MECHANICAL PERMIT

DUMB WAITER PUMPS COMPRESSED AIR, VACUUM, PNEUMATIC TUBES, CONVEYORS AND/OR MONORAILS FUNICULAR Box 2 (To be accomplished by the Design Professional) ...

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OFFICE OF THE BUILDING OFFICIAL

MECHANICAL PERMIT Application No.

MP No.

Building Permit No.

Box 1 (To be accomplished in print by the Owner/Applicant) LAST NAME

OWNER/APPLICANT FOR CONSTRUCTION OWNED BY AN ENTERPRISE NO. ADDRESS

FIRST NAME

FORM OF OWNERSHIP

STREET

LOCATION OF CONSTRUCTION

BARANGAY

LOT NO. ________

BLK NO.________

TIN

USE OR CHARACTER OF OCCUPANCY

CITY/MUNICIPALITY

BARANGAY __________________

STREET ________________ SCOPE OF WORK

M.I.

ZIP CODE

TCT NO. __________

TELEPHONE NO.

TAX DEC NO. ___________

CITY/MUNICIPALITY OF ________________________

NEW CONSTRUCTION

RENOVATION

RAISING

ERECTION

CONVERSION

ADDITION

REPAIR

ALTERATION

MOVING

DEMOLITION ACCESSORY BUILDING/ STRUCTURE OTHERS (Specify)

Box 2 (To be accomplished by the Design Professional) INSTALLATION AND OPERATION OF: BOILER

CENTRAL AIRCONDITIONING

PRESSURE VESSEL

MECHANICAL VENTILLATION

INTERNAL COMBUSTION ENGINE

ESCALATOR

REFRIGERATION MAKING

MOVING SIDEWALK

COMPRESSED AIR, VACUUM, INSTITUTIONAL AND/ INDUSTRIAL GAS

WINDOW TYPE AIRCONDITIONING

FREIGHT ELEVATOR

PACKAGED/SPLIT TYPE AIRCONDITIONING

PASSENGER ELEVATOR

PNEUMATIC TUBES, CONVEYORS AND/OR MONORAILS

OTHERS (Specify)

CABLE CAR

DUMB WAITER PUMPS

FUNICULAR

PREPARED BY

Box 3

Box 4

DESIGN PROFESSIONAL, PLANS AND SPECIFICATIONS

SUPERVISOR / IN-CHARGE OF MECHANICAL WORKS PROFESSIONAL MECHANICAL ENGINEER

PROFESSIONAL MECHANICAL ENGINEER

(Signed and Sealed over Printed Name)

(Signed and Sealed over Printed Name)

Date

Date Address PRC No. PTR No. Issued at Box 5 Building Owner

Address Validity PRC No. PTR No. Date Issued Issued at TIN Box 6 WITH MY CONSENT LOT OWNER

Validity Date Issued TIN

(Signature Over Printed Name) Date Address CTC No.

Date Issued

MECHANICAL ENGINEER

(Signature Over Printed Name) Date Place Issued

Address CTC No.

Date Issued

Place Issued

TO BE ACCOMPLISHED BY THE PROCESSING AND EVALUATION DIVISION

Box 6 DATE

RECEIVED BY

FIVE (5) SETS OF MECHANICAL DOCUMENTS MECHANICAL PLANS AND SPECIFICATIONS

COST ESTIMATES

OTHERS (Specify)

BILL OF MATERIAL

Box 7 PROGRESS FLOW IN

OUT

PROCESSED BY: DATE

TIME

DATE

TIME

MECHANICAL

CARIDAD J. MANIPON

OTHERS (Specify)

Chief, Building Code Section

Box 9 ACTION TAKEN PERMIT IS HEREBY ISSUED SUBJECT TO THE FOLLOWING: 1. That the proposed mechanical works shall be in accordance with the mechanical plans filed with this Office and in conformity with the provisions of the latest Philippine Mechanical Codes, the National Building Code and its IRR. 2. That prior to any mechanical installation, a duly accomplished prescribed “Notice of Construction” shall be submitted to the Office of the Building Official. 3. That upon completion of the mechanical works, the licensed supervisor/in-charge 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 mechanical works conform to the provisions of the Philippine Mechanical Code, the National Building Code and its IRR. 4. That this permit is null and void unless accompanied by the building permit. 5. That a Certificate of Operation shall be issued for the continuous use of mechanical installations.

PERMIT ISSUED BY:

MACARIO A. SEGUNDO JR. City Engineer/Building Official

Date _______________