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Application Form

This document is an application for a Fire Safety Evaluation Clearance (FSEC) or Fire Safety Inspection Certificate (FSIC) from the Bureau of Fire Protection. The application requests information about the applicant/owner, property details like number of floors and area, and location. It lists the required documents for the application like building plans, fire safety plans, and certificates. It notes that only complete applications will be processed and provides spaces for dates of application receipt and expected clearance/certificate release. The purpose is to evaluate fire safety of buildings and issue certifications required for occupancy permits or business licenses.

Uploaded by

Leah A. De Guzman
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
231 views

Application Form

This document is an application for a Fire Safety Evaluation Clearance (FSEC) or Fire Safety Inspection Certificate (FSIC) from the Bureau of Fire Protection. The application requests information about the applicant/owner, property details like number of floors and area, and location. It lists the required documents for the application like building plans, fire safety plans, and certificates. It notes that only complete applications will be processed and provides spaces for dates of application receipt and expected clearance/certificate release. The purpose is to evaluate fire safety of buildings and issue certifications required for occupancy permits or business licenses.

Uploaded by

Leah A. De Guzman
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Interior and Local Government


BUREAU OF FIRE PROTECTION
(Region)
(STATION)
(Station Address)

APPLICATION __________________
NO. ______________ Date
(To be filled up by applicant/owner)

Name of Applicant/Owner ________________________________________________________


Type of Building/Occupancy ______________________________________________________
Total Number of Floors __________________________________________________________
Total Floor Area ________________________________________________________________
Location/Address of Building/Establishment/Construction _______________________________

Requirements Submitted: (To be checked/filled up by the Customer Relations Officer)

FIRE SAFETY EVALUATION CLEARANCE FIRE SAFETY INSPECTION CERTIFICATE


(FSEC) (FSIC) FOR OCCUPANCY PERMIT OR
FOR BUSINESS PERMIT
Endorsement from the Building Official (BO) Endorsement from Building Official (BO)
Photocopy of Building Permit and Assessment of
Three (3) Sets of Building Plans and Specifications
Occupancy Permit Fee/Assessment of Application for Business
Permit/ BPLO Assessment/Tax Bill for Business Permit, as
One (1) set of Bills of Materials and Cost
the case maybe
Estimates
Copy of Fire Insurance Policy
Three (3) Sets of Detailed Fire Safety Plans and (If any, please specify) _______________________________
Specifications and Fire and Life Safety Assessment
Copy of LATEST Fire Safety Inspection Certificate
Report 1 (FALAR-1)I for Occupancy of at least 50
(FSIC) immediately preceding this application (if any)
persons
Three (3) Sets of Fire and Life Assessment Report-2 (FALAR-2)
or FALAR-3 for Business Permit (For Occupancy of at least 50
persons)

________________________________
SIGNATURE OF APPLICANT/OWNER
Time and Date Received: _____________________________________
Due for Release (FSEC with FS Checklist): _______________________
(FSIC/NTC): _________________________________ Certified By:

___________________________
Customer Relations Officer
Note: Only application with complete requirements shall be processed.
____________________ ____________ __________ _________________
CLAIM STUB
__________________
APPLICATION NO. ______________ Date

NAME OF APPLICANT/OWNER: _______________________________

Time and Date Received: _____________________________________


Due for Release (FSEC with FS Checklist): _______________________
(FSIC/NTC): _________________________________ Certified By:

_________________________________________
Customer Relations Officer

“FIRE SAFETY IS OUR MAIN CONCERN”

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