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Dee FORM NO 86.018
REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS
OFFICE OF THE LOCAL BUILDING OFFICIAL Ne 4495
Makati City
DISTRICTICITYIMUNICIPALITY
‘AREA CODE : 12000
APPLICATION NO. DATE APPLICATION FILLED
- Sua LICATION FOR ELECTRICAL/AUXILIARY PERMIT®
Date of Proposed Stat of siaiaton”"ABPLICATION FOR ELECTRICAL PERMIT ipecte Dae of Completion
(ecompssh inp nin supleat)
[20x {70 BE ACCOMPLISHED BY ADULY QUALIFIED ELECTRICAL PRACTTTIONER) _/ ELECTRONICS PRACTITIONER
‘NAME OF OWNERAPPLCANT UST NAME RST NAME IDOLE NAME TH
DRESS ca iREET EARANGN ‘CYRUNTALTY TELIA.
OGATION GF INSTALLATION. ¥0. ‘ineeT BARANGAY CaVRORCRRLTY
‘S60FE OF WORK (ap008 To EXISTING INSTALLATION Dlomens erecry
(Canew mstaLLaTion OREEAR OF ExSTINGINSTALLATION
ChsewaL msrecrion CUREMOVAL OF EXSTING INSTALLATION
"YE OF OCCUPANCY OR USE: i
CO ARESIENTIAL DWELLING De buses & MERCANTILE 5 LAssempey occuPaT Load 190 OR MORE
Ch B.RESDENTIAL,HOTEL APARTMENT. (DF NDUSTRIAL D L-acoessony
Bi CepucaTION & RECREATION DG STORAGE & nazanoous a
Gi o.mstinuriona. HaSSeMBLY OTHER THAN GROUP sige
NUMBER OF OUTLETS: NUMBER OF EQUPMENTIMIRING DEVICES:
—— Lai _—8P0, cooks UNIT ‘ToosLe siircH FADETECTORS
‘CONVENENCEIRECEPTACLE _SPO.WATER.HERTER BELLSUZZERS Toms (se At! 18)
0, arcon 0, ware PUN PUSH BUTTONS
BOX.2PROFESSIONAL ELECTRICAL ENGINEER WHO SIGNED AND SEALED PLANS A SPECIFICATIONS) / PROFESSIONAL ELECTRONICS ENGINEER
we PRC REG. NO. NUDITY
ADDRESS TELTFIR RO,
PARW DATE SST TEST
‘SIGNATRE ar sch ®
june Treeus.no. SREGAT LECTRIAT
“ 4
OK (PERSON IN CHARGE OF INSTALLATION)
SRP | Crecrenenaiccraca monte ee
wa FREREEN waar
"ADORESS TELIFAXNO.
PIR NO, "DATE NSSUED PLACE SUED
‘SIGNATURE ‘DATE SIGNED — - os TH :
BOX’ (OWNERIALTHORIZED REPRESENTATIVE)
Nae “SIGNATURE W BICNO.
= DATE ISSUED
PLAGE ISSUED.
BOX (70 BE RECEIVED BY RECEIVING RECORDING SECTION)
[RECEIVED By:
[AUXILIARY PLANS/
[ELECTRICAL PLANS & SPECIFICATIONS (6 SETS) ‘Sioneea ie Poea Nee
[NOTE Ths ELECTICAY/AUNIAARY PERM 1S SSUED WTHOUT PREIUDICETO ANY RULES AND REGULATIONS YO BE SUED BY DPW,
www.makati.gov.ph(OPWH FORM. 9bon2
REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF PUBLIC WORKS AND HIGHWAYS.
OFFICE OF THE LOCAL BUILDING OFFICIAL
Makati City
DISTRICTICITYIMUNICIPALITY
‘AREA CODE : 12000
PERMITNO. APPLICATION NO.
DaTEIssuED_— DATE FILED,
PAID UNDER OR. NO.
AMOUNT
DATE,
ELECTRICAL PERMIT
{Tobe Accomplished bythe Off Concamod)
Box
NAME OF OMNERAPPLCANT ASTRON, RST AE, THDOLE RARE] Tv
7ODRESS; NO, STREET, BARINGNY, CIYMUNIGPALITY | TELIFARNO.
[LOCATION OF INSTALLATION: ‘STREET, “BARANGAY, ‘CITYMONICIPALITY
0x2
ASSESSED FEES
TAWOUNT UE OR NOMGER DATEAD REVIENED &ASSESSED BY
20K
PERMIT IS HEREBY GRANTED TO INSTALL THE ELECTRICAL WIRING, DEVICES AND EQUIPMENT ENUMERATED IN THE APPLICATION
'SUBJECTTO THE FOLLOWING CONDITIONS:
4, THAT THE PROPOSED INSTALLATION BE IN ACCORDANCE WITH THE APPROVED PLANS FILED WITH THIS OFFICE AND IN
‘CONFIRMITY WITH THE PROVISIONS OF THELATEST EDITION OF THE PHILIPPINE ELECTRICAL CODE.
‘THATADULY LICENSED ELECTRICAL PRACTITIONER BE IN CHARGE OF THE INSTALLATIONICONSTRUCTION.
9, THATAGERTIFICATE OF COMPLETION DULY SIGNED BY THE ELECTRICAL PRACTITIONER INCHARGE OF THE INSTALLATION BE
‘SUBMITTED NOTLATER THAN SEVEN (7)DAYSAFTER COMPLETION OF THE INSTALLATION,
4, THATACERTIFICATE OF FINALELECTRICAL INSPECTIONBE SECURED PRIOR TO THEACTUAL OCCUPANCY OF THE BUILDING.
15, THISPERMITSHALL BE POSTEDATTHEDOORSITE OF WORK.
APPROVED:
‘Chief, Electrical Processing Section DATE
Elacrical Engineer of the Bldg. Office
| PROREG. No,
Noten:
iC, CITY BUILDING OFFICIAL
www.makatigov.