Republic of The Philippines
Department of Public Works And Highways
Metropolitan Manila Commission
Office of The Building Official
Magallanes, Cavite

District/City/Municipality
Area Code 4317

Application For Electrical Permit

Application No.

Date of Application

Section 1 To Be Accomplihed By Professional Electrical Engineer / Master Electrician

Owner / Applicant

First Name

M.I.

Last Name

Tax ID No.

House No., Street

Baranggay

Phone

Scope of Work

New Installation

Annual Inspection

Addition of

Repair of

Removal of

Use or Type of Occupancy

Residential

Commercial

Industrial

Agricultural

Parks, Plazas, Monuments

Recreational

Others (Specify)

Number of Outlets and Equipment to be Installed

Lights

BELLS SYSTEM

AIRCON SYSTEM

SWITCHES

ELECTRIC RANGE KW

TELEPHONE

CONV. OUTLETS

WATER HEATER KW

MOTORS

Others (Specify)

Date of Proposed Start of Construction

Estimated Cost of Electrical Installation

Expected Date of Completion

Prepared by

Section 2 To Be Accomplied By Receiving & Recording

Electrical Documents

Electrical Plan & Specifications

Cost Estimates

Bill of Materials

Others (Specify)

Section 3 Person who Signed and Sealed Plans Specification

Electrical Engineer / Master Electrician

PRC Reg. No.

Print Name

Address

PTR No.

Date Issued

Place Issued

TIN

Signature

PERSON IN-CHARGE OF THE INSTALLATIONS

Electrical Engineer / Master Electrician

PRC Reg. No.

Print Name

Address

PTR No.

Date Issued

Place Issued

TIN

Signature

Section 4

Owner

TIN

Res.Cert.No.

Date Issued

Place Issued

Signature

Section 5 To Be Accomplihed By Professional Electrical Engineer / Master Electrician

Owner / Applicant

First Name

M.I.

Last Name

Tax ID No.

House No., Street

Baranggay

Phone

Location of Construction

House No., Street

Baranggay

Phone

Section 6 To Be AccompliheD by Division / Section Concerned

Progress Flow

Chief, Processing Division Section

In Time

In Date

Out Time

Out Date

Action Remarks

Processed by

Receiving and Recording

In Time

In Date

Out Time

Out Date

Action Remarks

Processed by

Electrical

In Time

In Date

Out Time

Out Date

Action Remarks

Processed by

Section 7 To Be AccompliheD by Division / Section Concerned

Amount Due

Assesed by

O.R. Number

Date Paid

Amount Due

Assesed by

O.R. Number

Date Paid

Amount Due

Assesed by

O.R. Number

Date Paid

Reviewed: Chief, Processing Division/Section

Section 8 To be Accomplihed by the Building Official

Action Taken

Permit is hereby granted to install the sanitary/plumbing fixture enumerated herein subject to the following conditions:

That the proposed installation shall be in accordance with approved plans filed with this office and in conformity with the National Building Code.
That a duly licensed sanitary engineer/master plumber shall be engaged to undertake the installation/construction.
That a certificate of completion, duly signed by a sanitary engineer/master plumber in charge of the installation, shall be submitted not later than seven (7) days after completion of the installation.
That a certificate of final inspection and a certification and a certificate of occupancy be secured prior to the actual occupancy of the building.

Engr. Nelson E. Villa

Building Official

Date

Note: This permit may be cancelled or revoked pursuant to sections 305 & 308 of the "national building code"