Republic of the Philippines Department of Public Works and Highways OFFICE OF THE BUILDING OFFICIAL Quezon City APPLICATION

NO. PERMIT NO.

FENCING PERMIT

DATE OF APPLICATION BOX 1 (TO BE ACCOMPLISHED BY APPLICANT IN PRINT) Owner Applicant Construction Owned By an Enterprise LOCATION No. Last Name First Name M.I.

DATE ISSUED

Tax Acct.No.

Form of Ownership

Telephone

Street

Barangay

Address

No.

Street

Barangay

Scope of Work FENCE

New Renovation

Additional Change of Material

Repair Others

BOX 2 (TO BE ACCOMPLISHED BY RECEIVING & RECORDING SECTION) Documents/Requirements: Certified True Copy of TCT Contract of Lease Duly Notarized Plans & Designs of Fence Over 1.00m Tax Declaration/Current Tax Receipt Location Plan & Vicinity Map (5 sets) Others_________________________

BOX 3 (TO BE ACCOMPLISHED BY DESIGNING ARCHITECT/CIVIL ENGINEER/CONTRACTOR IN PRINT) Measurements in meters Length__________________ Height __________________ Excess __________________

Type of fencing:
Indineous R.C. (Reinforced Concrete) R.C. & Concrete Hollow Blocks R.C. & Blocks BOX 4 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIALS) R.C. & Interlink/Cyclone Wire R.C. & Steel Matting R.C. & Barbed Wire & Other Wires Others _______________________

ACTION TAKEN:
Permit is hereby granted subject to the following conditions: 1. THAT the proposed fence construction shall be in conformity with the National Building Code (P.D. 1996) and its corresponding implementing rules and regulations. 2. THAT other provisions of existing laws, decrees, rules and regulations shall be complied with. 3. THAT occupants of lot shall have free access to and from the property. 4. THAT the required setback / easement shall be observed. 5. THAT the property to be fenced is not involved in any case. 6. THAT electrical permit shall be secured when equipped with electrical devices.

ENGR. ISAGANI R. VERZOSA JR. Local Building Official

NOTE:

www.quezoncity.gov.ph OFFICE OF THE BUILDING OFFICIAL

This permit may be cancelled or revoked pursuant to Section 305 and 306 of the NATIONAL BUILDING CODE.

BOX 5 (TO BE ACCOMPLISHED BY THE DIVISION / SECTION CONCERNED) ASSESSED FEES AMOUNT DUE
( ( ( ( ) Line & Grade ) Fencing ) Electrical (if any) ) Others (Specify)

ASSESSED BY

O.R. NUMBER

DATE AIDE

TOTAL

REVIEWED

Chief Processing Div.

We hereby affix our hands signifying our conformity to the information herein above set forth.

BOX 6 (TO BE ACCOMPLISHED BY THE DIVISION / SECTION CONCERNED) PROGRESS FLOW

NOTED: Chief Processing Div. Receiving & Recording Geotic (Line Conformity) Structural Electrical Cashier We hereby affix our hands signifying our conformity to the information herein above set forth. IN Time Date Time OUT Date

ACTION

PROCESSED

BOX 7
Architect/Civil Engineer Signed & Sealed Print Name Address PTR. NO. Signature Date Issued Place Issued PRC REG .No. PRINT NAME Signature Res. Cert. Date Issued Place Issued

BOX 8
Architect/Civil Engineer Signed & Sealed Print Name Address PTR. NO. Signature Date Issued Place Issued TIN PRC REG .No. Architect/Civil Engineer Signed & Sealed Print Name Address PTR. NO. Signature Date Issued Place Issued TIN PRC REG .No.

www.quezoncity.gov.ph OFFICE OF THE BUILDING OFFICIAL