NBC FORM NO.

B - 01
Republic of the Philippines
City/Municipality of Mariveles
Province of Province of Bataan
OFFICE OF THE BUILDING OFFICIAL
APPLICATION FOR BUILDING PERMIT
NEW RENEWAL AMENDATORY
APPLICATION NO. AREA NO

BOX 1 (TO BE ACCOMPLISHED IN PRINT BY THE APPLICANT)

DO NOT FILL-UP (NSO USE ONLY)
OWNER/APPLICANT LAST NAME FIRST NAME M.I. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP

BY AN ENTERPRISE

ADDRESS: NO., STREET, BARANGAY, CITY/MUNICIPALITY ZIP CODE TELEPHONE NO.

LOCATION OF CONSTRUCTION: LOT NO. ______ BLK NO. ________ TCT NO. ______________ TAX DEC. NO. ____________________
STREET_____________________ BARANGAY __________________________ CITY/ MUNICIPALITY OF_______________________________
SCOPE OF WORK
NEW CONSTRUCTION RENOVATION RAISING
ERECTION CONVERSION ACCESSORY BUILDING/STRUCTURE
ADDITION REPAIR OTHERS (Specify)
ALTERATION MOVING
USE OR CHARACTER OF OCCUPANCY
GROUP A : RESIDENTIAL, DWELLINGS GROUP F : INDUSTRIAL OTHERS (Specify) ________________

GROUP B : RESIDENTIAL HOTEL, APARTMENT GROUP G : INDUSTRIAL STORAGE AND HAZARDOUS

GROUP C : EDUCATIONAL, RECREATIONAL GROUP H : RECREATIONAL, ASSEMBLY OCCUPANT LOAD LESS THAN 1000
GROUP D : INSTITUTIONAL GROUP I : RECREATIONAL, ASSEMBLY OCCUPANT LOAD 1000 OR MORE
GROUP E : BUSINESS AND MERCANTILE GROUP J : AGRICULTURAL, ACCESSORY

OCCUPANCY CLASSIFIED _________________________________________ TOTAL ESTIMATED COST P __________________________________

NUMBER OF UNITS_______________________________________________
PROPOSED DATE OF CONSTRUCTION _________________________
TOTAL FLOOR AREA ______________________________ SQUARE METERS
EXPECTED DATE OF COMPLETION____________________________
BOX 2 _______________________________________________
FULL-TIME INSPECTOR AND SUPERVISOR OF CONSTRUCTION WORKS (REPRESENTING THE OWNER)
Address

PRC No. Validity

ARCHITECT OR CIVIL ENGINEER PTR No. Date Issued

(Signed and Sealed Over Printed Name)
Date_____________________________ Issued at TIN
BOX 3 BOX 4
APPLICANT: WITH MY CONSENT: LOT OWNER

Date______________ Date______________
(Signature Over Printed Name) (Signature Over Printed Name)
Address Address
CTC No Date Issued Place Issued CTC No Date Issued Place Issued
BOX 5
REPUBLIC OF THE PHILIPPINES ) S.S
CITY/MUNICIPALITY OF __________________________________________)
BEFORE ME, at the City/Municipality of _____________________________________________________ , on _________________________ personally appeared
the following:
______________________________________________________ _______________ ______________ ___________________________________________
APPLICANT C.T.C. No. Date Issued Place Issued

______________________________________________________ _______________ ______________ ___________________________________________

LICENSED ARCHITECT OR CIVIL ENGINEER C.T.C. No. Date Issued Place Issued
(Full-Time Inspector and Supervisor of Construction Works)
whose signatures appear hereinabove, known to me to be the same persons who executed this 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. ________ NOTARY PUBLIC (Until December _____________ )
Series of ________
BOX 6 (TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION)
ASSESSED FEES ASSESSED BY AMOUNT DUE DATE PAID O.R. NUMBER NSO
FILING FEE
PROCESSING FEE
LOCATIONAL/ZONING OF LAND USE
LINE AND GRADE (Geodetic)
FENCING
ARCHITECTURAL
CIVIL/STRUCTURAL
ELECTRICAL
MECHANICAL
SANITARY
PLUMBING
ELECTRONICS
INTERIOR
ONE HALF () OF FIRE SERVICE FUND (FSF)
TOTAL
BOX 7 (TO BE ACCOMPLISHED BY THE BUILDING OFFICIAL)

BUILDING PERMIT NO.

BUILDING PERMIT OFFICIAL RECEIPT NO.

DATE ISSUED DATE PAID

M M D D Y Y M M D D Y Y
Permit is issued to__________________________for the proposed _________________________________
(Owner/Applicant) (Type of Project)
under____________________, of Group_____, located at Lot No._____Block No.______OCT/TCT No. ______,
(Use or Character of Occupancy)
_______________Street, Barangay_________________, City/Municipality of_______________________ subject to
the following:
1. That under Article 1723 of the Civil Code of the Philippines, the engineer or architect who drew up the plans and specifications for a building/structure is liable for
damages if within fifteen (15) years from the completion of the building/structure, the same should collapse due to defect in the plans or specifications or defects in
the ground. The engineer or architect who supervises the construction shall be solidarily liable with the contractor should the edifice collapse due to defect in the
construction or the use of inferior materials.
2. This permit shall be accompanied by the various applicable ancillary and accessory permits, plans and specifications signed and sealed by the corresponding design
professionals who shall be responsible for the comprehensive and correctness of the plans in compliance to the Code and its IRR and to all applicable referral codes
and professional regulatory laws.
3. That the proposed construction/erection/addition/alteration/renovation/conversion/repair/moving/demolition, etc. shall be in conformity with the provisions of the
National Building Code, and its IRR.
a. That prior to commencement of the proposed projects and construction an actual relocation survey shall be conducted by a duly licensed Geodetic Engineer.
b. That before commencing the excavation the person making or causing the excavation to be made shall notify in writing the owner of adjoining property not less
than ten (10) days before such excavation is to be made and show how the adjoining property should be protected.
c. That no person shall use or occupy a street, alley or public sidewalk for the performance of work covered by a building permit.
d. That no person shall perform any work on any building or structure adjacent to a public way in general use for pedestrian travel, unless the pedestrians are
protected.
e. That the supervising Architect/Civil Engineer shall keep at the jobsite at all times a logbook of daily construction activities wherein the actual daily progress of
construction including tests conducted, weather condition and other pertinent data are to be recorded, same shall be made available for scrutiny and
comments by the OBO representative during the conduct of his/her inspection pursuant to Section 207 of the National Building Code.
f. That upon completion of the construction, the said licensed supervising Architect/Civil Engineer shall submit to the Building Official duly signed and sealed
logbook, as-built plans and other documents and shall also prepare and submit a Certificate of Completion of the project stating that the construction of the
building/structure conform to the provision of the Code, its IRR as well as the plans and specifications.
g. All such changes, modifications and alterations shall likewise be submitted to the Building Official and the subsequent amendatory permit therefor issued
before any work on said changes, modifications and alterations shall be started. The as-built plans and specifications maybe just an orderly and
comprehensive compilation of all documents which include the originally submitted plans and specifications of all amendments thereto as actually built or they
may be an entirely new set of plans and specifications accurately describing and/or reflecting therein the building as actually built.
4. That no building/structure shall be used until the Building Official has issued a Certificate of Occupancy therefor as provided in the Code. However, a partial
Certificate of Occupancy may be issued for the Use/Occupancy of a portion or portions of a building/structure prior to the completion of the entire building/structure.
5. That this permit shall not serve as an exemption from securing written clearances from various government authorities exercising regulatory function affecting
buildings/structures.
6. When the construction is undertaken by contract, the work shall be done by a duly licensed and registered contractor pursuant to the provisions of the Contractors
License Law (RA 4566).
7. The Owner/Permittee shall submit a duly accomplished prescribed Notice of Construction to the Office of the Building Official prior to any construction activity.
8. The Owner/Permittee shall put a Building Permit sign which complies with the prescribed dimensions and information, which shall remain posted on the construction
site for the duration of the construction.

PERMIT ISSUED BY:

ILDEFONSO G. TARRIELA,JR

BUILDING OFFICIAL
(Signature Over Printed Name)
Date _________________
NOTE : THIS PERMIT MAY BE CANCELLED OR REVOKED PURSUANT TO SECTIONS 305 AND 306 OF THE NATIONAL BUILDING CODE