WORK PERMIT

APPLICANT’S INFORMATION
Applicant’s Name: Tower/Unit No. Date Applied (mm/dd/yyyy):
Jeraldine Custodio Tower 2 - Unit 814 12/16/24
(Must be at least 3 days before date of work)

Applicant is:  Owner  Tenant  Contractor (common area) Contact Number: Date of Work (mm/dd/yyyy):
 Authorized Representative 12/16-19/24
(Except Weekends and Holidays)

REQUIREMENTS
For Owner For Non-Owner
 Owner is a member in good standing  Unit Owner is a member in good standing
 Filled out Job Hazard Analysis (see table at the back page)  Filled out Job Hazard Analysis (see table at the back page)
 For Tenant - Letter of Authorization from the Owner
 For Authorized Representative – Special Power of Attorney
WORK DESCRIPTION
Type of Work Details of the Work:
 Carpentry  Electrical Painting and installation of cabinets
 Plumbing  Painting
 Mechanical  Layout
Start Date End Date Total Days
Work Duration
12/03/24 12/19/24 15 days
(Must not be more than 7 days)

CONTRACTOR DETAILS
Company Name: Address: Office Number:
JB Modular Cabinet
Contact Person: Contact Number: Email Address:
Jonel L. Barbo 09518464478 [email protected]
MANPOWER & TOOLS DETAILS
Manpower Tools & Equipment
Worker’s Name Position Particular/Description Quantity
John Lowrens Alarcio installer Portable drill 2
Ramer Baniel installer Grinder 1
Leonardo Tapiador painter Ladder 1
Randy Competente painter Electrical cord Extension 1

Use another sheet for additional entries

REMINDERS FOR THE CONTRACTOR/WORKERS
 Post the Work Permit at the exterior face of the main door or gate  Coordinate with the Admin for the proper disposal of trash
 At least one (1) 20lbs fire extinguisher should be at the site
UNDERTAKING
I hereby acknowledge that I have read and fully understood the house rules Avida Towers Makati Southpoint regarding construction and
renovation/repair works. I accept and agree to all the terms and conditions stated therein.
I shall be responsible for the actions of my workers and shall hold Avida Towers Makati Southpoint free from any liability from any
untoward incidents, injuries and damages caused by my workers.
I warrant that all information provided or attached are true and accurate in all respects and hereby give full consent to Avida Towers
Makati Southpoint to process the same, whether personal, sensitive or privileged, pertaining to myself which will be used for or in relation to
my application for a work permit.

Jeraldine Custodio
Applicant / Date
Signature over Printed Name
VERIFICATION & APPROVAL
 Owner is a member in good standing  Work described is allowed per Design Guidelines and House Rules
 Required attachments are complete  No hot work activities involved

Administrative Assistant / Date Property Engineer / Date

Signature over Printed Name Signature over Printed Name

Approved by:

Property Manager / Date

Signature over Printed Name

Distribution: 1 – Owner’s Copy, 1 – Admin Office (Owner’s 201 Folder)

 ISSUANCE OF A WORK PERMIT
1. Work Permit will only be issued for Minor Works which is defined as superficial in nature
such as installation of furniture and appliances, backsplash, change of lights, installation
of fixtures, minor carpentry, painting and other minor works not lasting more than seven
(7) days.
2. All works that will last for more than seven (7) days and those considered as Major
Renovation Work will require a Renovation Permit instead. Examples of Major
Renovation works:
a. Drop ceiling
b. Replacement of Tiles in CR
c. Combination of rooms
d. Additional partitions
e. Additional electrical circuits
TERMS AND CONDITIONS
1. Work permit application shall be accomplished and submitted at least three (3) days prior
to work commencement.
2. A Job Hazard Analysis (JHA), signed by the Safety Officer / Person-In-Charge of the
work, covering all activities stated in this permit shall be submitted together with this
Work Permit application.

SAMPLE FORM:
ACTIVITY:

HAZARDS / IMPACT CONTROL MEASURES to

ACTIVITY PROCEDURE / STEPS of the PROCEDURE Implement for the HAZARDS

3. Works shall not be allowed to proceed if the required one (1) unit of 20-lb ABC fire
extinguisher is not at the work site.
4. All works to be done should not cause damage to the building facilities or exceed utility
capacities of the unit and should comply with pertinent government and safety regulations
and shall be in accordance with the House Rules and Design & Construction Guidelines.
5. Measures should be put in place to minimize spread of odor/mists to adjacent units and
hallways when painting. The Property Management has the right to confiscate the
materials and equipment which are used for painting or spraying.
6. Work stoppage shall be implemented if work being done is affecting adjacent units or
common areas.
7. If the owner/workers continue to defy work stoppage or other orders, Property
Management has the right to confiscate materials or equipment to effect the stoppage.
8. Tampering of Work Permit shall automatically render the work permit void.
MANPOWER & TOOLS DETAILS (Continuation from front page)
Manpower Tools & Equipment
Worker’s Name Position Particular/Description Quantity