NBC FORM NO.

A- 01
REPUBLIC OF THE PHILIPPINES
PROVINCE OF SURIGAO DEL NORTE
MUNICIPALITY OF GENERAL LUNA
OFFICE OF THE BUILDING OFFICIAL

ARCHITECTURAL PERMIT
APPLICATION NO. AP NO. BUILDING PERMIT NO.

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

OWNER/APPLICANT LAST NAME, FIRST NAME, MI. TIN

FOR CONSTRUCTION OWNED FORM OF OWNERSHIP USE OR CHARACTER OF OCCUPANCY

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 GENERAL LUNA, SURIGAO DEL NORTE
SCOPE OF WORK
 NEW CONSTRUCTION  RENOVATION _________________________  RAISING__________________________
 ERECTION  CONVERSION _________________________  ACCESSORY BUILDING ______________
 ADDITION  REPAIR ______________________________  OTHERS (Specify)___________________
 ALTERATION  MOVING ____________________________ _________________________________

BOX 2(TO BE ACCOMPLISHED BY THE DESIGN PROFESSIONAL)

1.ARCHITECTURAL FACILITIES AND OTHER FEATURES PURSUANT TO BATAS PAMBANSA BILANG 344, REQUIRING CERTAIN
BUILDINGS, INSTITUTIONS, ESTABLISHMENTS AND UTILITIES TO INSTALL FACILITIES AND OTHER DEVICES.
 STAIRS  WASH ROOMS AND TOILETS  SWITCHES, CONTROLS, BUZZERS  DRINKING FOUNTAINS
 WALKWAYS  LIFTS/ ELEVATORS  HANDRAILS  PUBLIC TELEPHONES
 CORRIDORS  RAMPS  THRESHOLDS  SEATING ACCOMMODATIONS
 DOORS, ENTRANCES & THRESHOLDS  PARKING AREAS FLOOR FINISHES  OTHERS (Specify)__________
2. PERCENTAGE OF SITE OCCUPANCY 3. CONFORMANCE TO FIRE CODE OF THE PHILIPPINES(P.D. 1185)
PERCENTAGE OF BUILDING FOOTPRINTS _______% NUMBER AND WIDTH OF EXIT DOORSFIREWALLS OTHERS(Specify)___
PERCENTAGE OF IMPERVIOUS SURFACE AREA ___% WIDTH OF CORRIDORS FIRE FIGHTING AND SAFETY FACILITIES
PERCENTAGE OF UNPAVED SURFACE AREA _____% DISTANCE TO FIRE EXITS SMOKE DETECTORS
OTHERS (Specify) ___________________________ ACCESS TO PUBLIC STREET EMERGENCY LIGHTS

BOX 3 BOX 4
DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS SUPERVISOR/ IN-CHARGE OF ARCHITECTURAL WORKS

__________________________________ ___________________________________
ARCHITECT ARCHITECT
(Signed and Sealed Over Printed Name) (Signed and Sealed Over Printed Name)
Date ________________ Date _______________
Address Address
PRC No. Validity PRC No. Validity
IAPOA No. OR No. Date Issued IAPOA No. OR No. Date Issued
PTR No. Place Issued Date Issued PTR No. Place Issued Date Issued
TIN TIN

BOX 5 BOX 6
BUILDING OWNER WITH MY CONSENT: LOT OWNER

___________________________ ________________________
(Signature Over Printed Name) (Signature Over Printed Name)
Date_______________ Date_______________
Address Address

CTC No. Date Issued Place Issued CTC No. Date Issued Place Issued
TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

BOX 7
RECEIVED BY DATE
FOUR (4) SETS OF ARCHITECTURAL DOCUMENTS

 1. VICINITY MAP/ LOCATION PLAN WITHIN A TWO-  8. DETAILS OF RAMPS, PARKING FOR THE DISABLED,STAIRS,
KILOMETER RADIUS FIRE ESCAPES, CABINETS AND PARTITIONS
 2. SITE DEVELOPMENT PLAN  9. SCHEDULE OF DOORS AND WINDOWS
 3. PERSPECTIVE  10. SCHEDULE OF FINISHES FOR FLOORS,CEILINGS AND WALLS
 4. FLOOR PLANS  11. ARCHITECTURAL INTERIOR
 5. ELEVATIONS, AT LEAST FOUR (4)  12. SPECIFICATIONS
 6. SECTIONS, AT LEAST TWO (2)  13. COST ESTIMATE
 7. CEILING PLANS SHOWING LIGHTING FIXTURES AND  14. OTHERS (Specify)
DIFFUSERS ________________________________________________
________________________________________________

BOX 8
PROGRESS FLOW
IN OUT
PROCESSED BY
DATE TIME DATE TIME
ARCHITECTURAL DRAWINGS

SPECIFICATIONS

OTHERS (Specify)

BOX 9

ACTION TAKEN

PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING:

1. That under Article 1723 0f the Civil Code of the Philippines, the Architect (and Engineer) who drew up the plans
and specifications for the building/ structure is responsible 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. That the proposed architectural works shall be in accordance with the architectural plans filed with this Office
and inconformity with the latest Architectural Code of the Philippines, the National Building Code and its IRR.
3. That prior to any construction activity, a duly accomplished prescribed “Notice of Construction” shall be
submitted to the Office of the Building Official.
4. That upon completion of the construction, the licensed full-time inspector and supervisor/in-charge of
construction works shall submit the entry to the logbook duly signed and sealed to the Building Official including
as-built plans and other documents, and shall also accomplish the Certificate of Completion stating that the
architectural works conform to the provisions of the Architectural Code, the National Building Code and its IRR.
5. That this permit is null and void unless accompanied by the Building Permit.

PERMIT ISSUED BY:

_QUIRICO C. CUIZON_
BUILDING OFFICIAL
(Signature Over Printed Name)
Date ____________________