Electronics Completion Form

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DBO 1/12/23, 2:39 PM

Republic of the Philippines


Quezon City
DEPARTMENT OF THE BUILDING
OFFICIAL

CERTIFICATE OF COMPLETION
(ELECTRONICS)

Control No.:   
  OCC-111202385957
OCC-111202385957  
   Date: ____________________________

THIS CERTIFIES THAT the electronics installed in the project owned by   


located at
entitled APPLICATION FOR OCCUPANCY PERMIT
and covered by Electronics Permit Issued on
No.
Under Building Permit Issued on
No.
has been completed in accordance with the approved plans ans speci\cations, and provisions of the National Building
Code of the Philippines (P.D. 1096), Its Implementing Rules and Regulation (IRR), and the Philippine Electronics Code.

That the total cost of the Electronics Project is  


    
  .
That the installation is ready for \nal inspection by the Electronics Engineer of the Quezon City Department of the
Building Of\cial.
Issued this ______________ day of __________________ in Quezon City.

Total Number of Devices and Equipment Installed:


(Note: List Down the installed electronic devices and/or equipment (Quantity and Description))

PECE In-Charge of CONTRACTOR


Installation
Licenso No.:
PRC Reg. No.: __________________________
_________________________ T.I.N.:
PTR No.: _________________________________
______________________________
Date Issued:
__________________________
Placed Issued:
________________________
T.I.N.:
_________________________________

REQUEST is herein submitted for Final Inspection of the above installation. Following are contact details and information
for your perusal.

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DBO 1/12/23, 2:39 PM

Owner/Representative:       
                 Contact No.:           
                    
          
Contractor/Representative: Contact No.: _________________________
_____________________

Submitted by:   
Owner / Authorized Representative
(Signature over printed name)

RECEIVED BY: _________________________


DATE: _________________________________

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