FENCING PERMIT - City Government of Ormoc

NBC FORM NO. B-03Republic of the PhilippinesCity of ORMOCProvince of LEYTEOFFICE OF THE BUILDING OFFICIALFENCING PERMITAPPICATION NO. FP NO. BUILDING PERMIT NO.BOX 1 (TO BE ACCOMPLISHED BY THE OWNER/APPLICANT)OWNER/APPLICANT LAST NAME FIRST NAME M.I. TINFOR CONSTRUCTION OWNEDBY AN ENTERPRISEFORM OF OWNERSHIPADDRESS NO. STREET BARANGAY CITY/MUNICIPALITY ZIP CODE TELEPHONE NO.LOCATION OF CONSTRUCTION LOT NO. BLK NO. TCT NO. TAX DEC. NO.STREET BARANGAY CITY/MUNICIPALITYSCOPE OF WORKSCOPE OF WORK REPAIR OTHERS (Specify)ERECTIONDEMOLITIONADDITIONBOX 2 BOX 3DESIGN PROFESSIONAL PLANS AND SPECIFICATIONSFULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKSDATEDATEARCHITECT OR CIVIL ENGINEER(Signed and Sealed Over Printed Name)ARCHITECT OR CIVIL ENGINEER(Signed and Sealed Over Printed Name)AddressAddressPRC No. Validity PRC No. ValidityPTR No. Date Issued PTR No. Date IssuedIssued At TIN Issued At TINBOX 4 (TO BE ACCOMPLISHED BY THE APPLICANTAPPLICANTWITH MY CONSENT: LOT OWNER(Signature Over Printer Name )(Signature Over Printer Name)DateDateAddressAddressCTC No. Date Issued Place Issued CTC No. Date Issued Place IssuedBOX 5REPUBLIC OF THE PHILIPPINES )CITY/MUNICIPALITY OF )S.S.BEFORE ME at the City/Municipality of ,on personally appeared the followingAPPLICANTCTC No. Date Issued Place IssuedLICENSED ARCHITECT OR CIVIL ENGINEER CTC No. Date Issued Place IssuedFull Time Inspector and Supervisor of Fencing Workswhose signatures appear herein above, known to me to be the same persons who executed the standard prescribed form and acknowledged to me that the same is their free and voluntary act and deed.WITNESS MY HAND AND SEAL on the date and place above written.Doc. No.Page No.Book No.Series No.BOX 6 (TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)NOTARY PUBLIC (Until December )MEASUREMENTS LENGTH IN METERSTYPE OF FENCING INDIGENOUS MATERIALS R.C. STEEL MATTINGR.C. (Reinforced Concrete) R.C. BARBED WIRER.C. and CONCRETE HOLLOW BLOCKS OTHERS (Specify)R.C. and BRICKSR.C. and INTERLINK/CYCLONE WIRE