NBC FORM NO.

B - 19
Republic of the Philippines
City/Municipality Of _____________________
Certificate of Annual Inspection Province of __________________________________

OFFICE OF THE BUILDING OFFICIAL

Name of Owner/Lessee

Located at/Along Certificate of Annual Inspection

No.
Character of Occupancy Group Fee Paid
Official Receipt No.
A Certification duly signed and sealed from a duly licensed Date Paid
Architect/Civil Engineer, Professional Electrical Engineer/
Electronics Engineer/Professional Mechanical Engineer, Master
Date Issued
Plumber and Sanitary Engineer hired by the owner was submitted and
who undertook the annual inspection
pection that the Building/Structure is This Certificate of Annual Inspection is issued/granted pursuant to pertinent
Architecturally presentable, Structurally safe, the Electrical/ provision of the National Building Code (PD 1096) and its Implementing Rules and Regulations.
Electronics/Mechanical/Plumbing/Sanitary installations are in order. Name of Owner/Lessee
Character of Occupancy Group
Located at/along
Verified as to the following requirements
The Owner/Lessee shall properly maintain the building/structure to enhance
architectural well-being,
being, structural stability, electrical, mechanical sanitation, plumbing,
Locational/Zoning Line and Grade Architectural
of land Use (Geodetic)
electronics, interior design and fire-protective
protective properties and shall not be occupied or used
for purposes other than its intended use as stated above.

Civil/Structural Electrical Mechanical No alteration/Addition/Repairs/New Electrical/Electronics and/or Mechanical/

Plumbing/Sanitary installations shall be made thereon without a permit therefor.

Sanitary Plumbing Electronics The architect

rchitect or engineer who drew up the plans and specifications for the
building/structure is aware that under article 1723 of the Civil Code of the Philippines he is
responsible for damages if within fifteen (15) years from the completion of the structure, the
Interior Design Accessibility Fire Safety same should collapse due to defect in the plans or specifications or defects in the ground. He
is therefore enjoined to conduct annual inspections of the structure to ensure that the
conditions under which the structure was designed are not being viola
violated or abused.
Others (Specify)
A certified copy hereof shall be posted within the premises of the building and shall not be
The above-described
described building/structure covered by Certificate of removed without authority from the Building Official.
Occupancy No._____________issued on____________________has been verified
and found substantially satisfactory complied, therefore the
“Certificate of Annual Inspection” is hereby recommended for
issuance.
BUILDING OFFICIAL
(Signature Over Printed Name)
Date_____________________
Chief Chief
Inspection and Enforcement Division Processing and Evaluation Division NOTE:
(Signature Over Printed Name) (Signature Over Printed name) The owner/occupant of the building under the character of occupancy, group b to j shall notify
Date__________________________ Date__________________________ in writing the office of the Building Official for the granting/
granting/issuance of an annual inspection
certificate after one (1) year from the date of the issuance of this certificate and yearly thereafter.