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					                                              Republic of the Philippines
                                                 CITY OF MARIKINA

                                      MARIKINA SETTLEMENTS OFFICE

                                                                                         CONTROL NO. _________________



                       BUILDING CLEARANCE APPLICATION FORM



        I, Mr./Mrs./Ms. ______________________________________________________________, of legal age
                                                              (Name of Applicant)

is applying for an Building Permit / Clearance at my residence located at _______________________________

_____________________________________________________________________.

        FOR BUILDING CLEARANCE APPLICATION:
                 (Pls. check scope of work)

        _________           New Construction

        _________           Renovation: If renovation, submit picture and previously approved building permit

        _________           Others: specify              _________________________

                                                         _________________________


        That I am duly a member of _______________________________________________________________
                                                                          (Name of Community Association)

and a legitimate beneficiary of the socialized housing program.


        That I certify to the best of my knowledge and ability to the truthfulness of the above-mentioned
information. Any misrepresentation on information shall invalidate the application and cause revocation of
lot allocation award.


        In view of the foregoing, I am submitting the following documents to support my application (pls.
check corresponding):

        Photocopy of valid ID of applicant/ representative
        Certification of Community Association
        Notarized Affidavit of Waiver
        Notarized Authorization Letter/S.P.A.                                                ___________________________
                                                                                                     (Applicant Signature)
        Birth Certificate/Marriage Contract/Death Certificate
        TCT / NHA Certification / SHFC Substitution Approval                                 ___________________________
        Engineer Certification for Structural Stability (2-storey concrete and above/                       (Date)
         Photocopies of PRC ID or Business Permit from BPLO-Marikina)
        Location Sketch                                                                      ___________________________
                                                                                                      (Tel. No. / Cell No.)
        Others: (pls. Indicate)
         ___________________________________________________
         ___________________________________________________


RECEIVED BY:                                                                 APPLICATION FORM RELEASED BY:

Name: _______________________________                                        Name: ______________________________
Signature: ____________________________                                      Signature: ___________________________
Date: ________________________________                                       Date: _______________________________
                                        Republic of the Philippines
                                           CITY OF MARIKINA

                                MARIKINA SETTLEMENTS OFFICE

                                                                           CONTROL NO. _________________



                        WATER CLEARANCE APPLICATION FORM



        I, Mr./Mrs./Ms. ______________________________________________________________, of legal age
                                                     (Name of Applicant)

is applying for a Water Permit / Clearance at my residence located at __________________________________

_____________________________________________________________________.

        FOR WATER CLEARANCE APPLICATION:
               (Pls. check scope of work)

        _________       Installation

        _________       Relocation of Meter

        _________       Others: specify         _________________________

                                                _________________________


        That I am duly a member of _______________________________________________________________
                                                                (Name of Community Association)

and a legitimate beneficiary of the socialized housing program.


        That I certify to the best of my knowledge and ability to the truthfulness of the above-mentioned
information. Any misrepresentation on information shall invalidate the application and cause revocation of
lot allocation award.


        In view of the foregoing, I am submitting the following documents to support my application (pls.
check corresponding):

          Photocopy of valid ID of applicant/ representative
          Certification of Community Association                                  ___________________________
          Notarized Affidavit of Waiver                                                   (Applicant Signature)
          Notarized Authorization Letter/S.P.A.
          Birth Certificate/Marriage Contract/Death Certificate                   ___________________________
                                                                                                   (Date)
          Location Sketch
          Others: (pls. Indicate)                                                 ___________________________
           ___________________________________________________                              (Tel. No. / Cell No.)
           ___________________________________________________


RECEIVED BY:                                                       APPLICATION FORM RELEASED BY:

Name: _______________________________                              Name: ______________________________
Signature: ____________________________                            Signature: ___________________________
Date: ________________________________                             Date: _______________________________
                                        Republic of the Philippines
                                           CITY OF MARIKINA

                                MARIKINA SETTLEMENTS OFFICE

                                                                           CONTROL NO. _________________



                  ELECTRICAL CLEARANCE APPLICATION FORM



        I, Mr./Mrs./Ms. ______________________________________________________________, of legal age
                                                     (Name of Applicant)

is applying for an Electrical Permit / Clearance at my residence located at ______________________________

_____________________________________________________________________.

        FOR ELECTRICAL CLEARANCE APPLICATION:
                 (Pls. check scope of work)

        _________       Additional              _________          New

        _________       Reconnection

        _________       Others: specify         _________________________

                                                _________________________


        That I am duly a member of _______________________________________________________________
                                                                (Name of Community Association)

and a legitimate beneficiary of the socialized housing program.


        That I certify to the best of my knowledge and ability to the truthfulness of the above-mentioned
information. Any misrepresentation on information shall invalidate the application and cause revocation of
lot allocation award.


        In view of the foregoing, I am submitting the following documents to support my application (pls.
check corresponding):

          Photocopy of valid ID of applicant/ representative
          Certification of Community Association
          Notarized Affidavit of Waiver
          Notarized Authorization Letter/S.P.A.                                   ___________________________
                                                                                           (Applicant Signature)
          Birth Certificate/Marriage Contract/Death Certificate
          TCT / NHA Certification / SHFC Substitution Approval                    ___________________________
          Certification of Lot Allocation (COLA)                                                  (Date)
          Certification of Award of Occupancy
          Relocation Order (R.O.)                                                 ___________________________
                                                                                            (Tel. No. / Cell No.)
          Others: (pls. Indicate)
           ___________________________________________________
           ___________________________________________________


RECEIVED BY:                                                       APPLICATION FORM RELEASED BY:

Name: _______________________________                              Name: ______________________________
Signature: ____________________________                            Signature: ___________________________
Date: ________________________________                             Date: _______________________________
                                        Republic of the Philippines
                                           CITY OF MARIKINA

                                MARIKINA SETTLEMENTS OFFICE

                                                                           CONTROL NO. _________________



                    BUSINESS CLEARANCE APPLICATION FORM



        I, Mr./Mrs./Ms. ______________________________________________________________, of legal age
                                                     (Name of Applicant)

is applying for a Business Permit / Clearance at my residence located at ________________________________

_____________________________________________________________________.

        FOR BUSINESS CLEARANCE APPLICATION:
               (Pls. check scope of work)

        _________       Name of Business or Trade Name: __________________________________________

        _________       Nature of Business: ______________________________________________________

        _________       If Renting: Name & Address of Owner: _____________________________________

        _________       Others: specify         _________________________

                                                _________________________


        That I am duly a member of _______________________________________________________________
                                                                (Name of Community Association)

and a legitimate beneficiary of the socialized housing program.


        That I certify to the best of my knowledge and ability to the truthfulness of the above-mentioned
information. Any misrepresentation on information shall invalidate the application and cause revocation of
lot allocation award.


        In view of the foregoing, I am submitting the following documents to support my application (pls.
check corresponding):

          Photocopy of valid ID of applicant/ representative
          Certification of Community Association                                  ___________________________
          Notarized Affidavit of Waiver                                                   (Applicant Signature)
          Notarized Authorization Letter/S.P.A.
          Birth Certificate/Marriage Contract/Death Certificate                   ___________________________
                                                                                                   (Date)
          Location Sketch
          Others: (pls. Indicate)                                                 ___________________________
           ___________________________________________________                              (Tel. No. / Cell No.)
           ___________________________________________________


RECEIVED BY:                                                       APPLICATION FORM RELEASED BY:

Name: _______________________________                              Name: ______________________________
Signature: ____________________________                            Signature: ___________________________
Date: ________________________________                             Date: _______________________________

				
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