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Certificate of Operation Air-Conditioning & Refrigeration

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NBC form no.

M - 10 Republic of the Philippines


City/Municipality of _____________________
Certificate of Operation: Air- Province of __________________________________

Conditioning/Refrigeration OFFICE OF THE BUILDING OFFICIAL

Name of Owner/Lessee
Certificate of Operation: Air-
Located at/along
Conditioning/Refrigeration
No.
Fee Paid
A certificate was submitted by _________________________________________ Official Receipt No.
(name)
a duly licensed professional mechanical engineer hired by the owner Date Paid
who undertook the mechanical inspections and that the installation is Date Issued
in order.
This Certificate of Operation: Air-Conditioning/Refrigeration is issued/granted
Verified as to the following pursuant to pertinent provision of the latest Philippine Mechanical Code, the National
Units, Refrigeration……………………… tons Building code and its Implementing rules and Regulations.

Units, Ice Plant………………………………. tons Name of Owner/Lessee ____________________________________________________________________


Units, Central A.C…………………………. tons Located at/along__________________________________________________________________________
Units, Packaged A.C. ..…………………… tons _________________ Units, Refrigeration _________________ tons
Units, Window Type A.C……………….. H.P. _________________ Units, Ice Plant _________________ tons
Units, Mechanical Ventilation……... H.P. _________________ Units, Central A.C. _________________ tons
_________________ Units, Packaged A.C. _________________ tons
Verified on _________________ Units, Window Type A.C. _________________ H.P.
Date of Expiration _________________ Units, Mechanical Ventilation _________________ H.P.
Inspection fee paid The owner/lessee shall properly maintain the equipment/machineries to ensure its safe
Official Receipt No. operation.
Date Issued No change, addition or upgrading/alteration deviating from the original mechanical plans
shall be made without appropriate permit.
The above described mechanical installation covered by Mechanical
Permit No.________________________ issued on_______________________ has been The aforementioned Air-Conditioning/Refrigeration may now be operated for a
found substantially satisfactory complied, therefore the
period of one (1) year from the date of inspection.
“Certificate of Operation: Air-Conditioning/
The owner/lessee of the building/structure shall notify in writing the office of the
Refrigeration” is hereby recommended for issuance.
building official for the granting/issuance of a Certificate of Operation: Air-
Conditioning/ Refrigeration for a period of one (1) year from the date of issuance of this
Mechanical Inspector Chief, Mechanical Section
(Signature Over Printed Name) (Signature Over Printed Name) certificate and yearly thereafter.
Date_______________________ Date_______________________
A certified copy hereof shall be posted within the premises of the building and shall not be
_______________ ______________ _______________ ______________
PRC Reg. No. validity PRC Reg. No. validity removed without authority from the building official.

Chief, Chief,
Inspection and Enforcement Division Processing and Evaluation Division Building Official
(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)
Date________________________
Date________________________ Date________________________

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