DBO 1/12/23, 2:39 PM
Republic of the Philippines
Quezon City
DEPARTMENT OF THE BUILDING
OFFICIAL
1st-3rd Floor Building Regulatory OfJce (Civic Center D) QC
Hall Compound, Quezon City
CERTIFICATE OF COMPLETION
(SANITARY/PLUMBING
INSTALLATION)
This to certify that the sanitary/plumbing installation/s of the subject building/structure hereunder stated with
Sanitary/Plumbing Permit No. _______________________________________ issued on __________________________ has been
completed through the actual supervision by the undersigned in accordance with the provisions of the National Building
Code of the Philippines (PD 1096) and to its latest referral codes as provided in the Plumbing and Sanitary Engineering
Codes, Sanitation Code of the Philippines (PD 856), QC Green Building Code and other related codes and directives.
PROJECT : Application for Occupancy Permit
LOCATION :
OWNER :
NOTE: Please Jll-up the following.
SOURCE OF WATER :
SEWAGE SYSTEM :
STORM DRAINAGE :
SUPERVISION/IN-CHARGE OF INSTALLATION: CONFORME:
Registered Sanitary Engineer/Master Plumber Owner / Applicant or Authorized
(Signed and Sealed Over Printed Name) Representative (Print Name/Signed Above)
Date :
PRC No :
PTR No :
Issued at :
Date Issued :
TIN :
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