BOX 3A (TO BE ACCOMPLISHED BY DESIGN ARCHITECTICIVIL ENGINEER IN PRINT) TOTAL ESTIMATED COST BUILDING ELECTRICAL MECHANICAL PLUMBING OTHERS ‘COST OF EQUIPMENT INSTALLED TOTAL P. NUMBER OF STOREYS ‘TOTAL FLOOR AREA PROPOSED DATE OF CONSTRUCTION, EXPECT OATE (OF COMPLETION MATERIAL OF CONST. twooD, ‘DO NOT FILL UP (NSO USE ONLY) ‘STEEL, MIKED} |BOX 4 (TO BE ACCOMPLISHED BY THE DIVISION/SECTION CONCERNED) ‘ASSESSED FEES AMOUNT DUE: ASSESSED BY (OR. NUMBER DATE PAID LAND USE/ZONING LINE AND GRADE BUILDING PLUMBING ELECTRICAL MECHANICAL OTHERS, TOTAL REVIEWED: CHIEF, PROCESSING DIVISION/SECTION (BOX 5 (TO BE ACCOMPLISHED BY THE SECTION CONCERNED) PROGRESS FLOW NOTED: CHIEF, PROCESSING ot ACTION) DIVISION/SECTION TIME DATE TIME DATE REMARKS PROCESSED BY RECEIVING AND RECORDING LAND USE AND ZONING (GEODETIC (LINE AND GRADE) ‘ARCHITECTURAL ‘STRUCTURAL SANITARYIPLUMBING ELECTRICAL MECHANICAL, BOx6 "WE HEREBY AFFIX OUR HANDS SIGNIFYING OUR CONFORMITY TO THE INFORMATION HEREIN ABOVE SET FORTH, 0x8 [ARCHITECTICL ENGINEER SIGNED AND SEALED PLANS AND SPECIFICATIONS PRC REG. NO. PRINT NAME ‘SIGNATURE [APPLICANT ADDRESS (COMMUNITY TAK me DATE ISSUED PLACE ISSUED PTRNO. ‘SIGNATURE B0x7, \WiTH My CONSENT BOX 9 (TO BE ACCOMPLISHED BY LOT OWNER) ‘ARGAITECTIONTCENGIEER INGHARGE OF CONSTRUCTION PRCREG NO [rerroct no. PRINT NAME PRINT NAME OF LOT OWNER ADDRESS |ADORESS. PTR NO. ‘BATE ISSUED PLAGE ISSUED |COMMUNITY TAX CERT. SIGNATURE TN [SIGNATURE