NOTE: ALL SHEETS MUST BE REVIEWED
MIAMI-DADE COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES
Herbert S. Saffir Permitting and Inspection Center
11805 SW 26th Street (Coral Way) • Miami, Florida 33175-2474 • (786) 315-2000
APPLICATION FOR MUNICIPAL PERMIT APPLICANTS
THAT REQUIRE PLAN REVIEW FROM MIAMI-DADE FIRE RESCUE
AND/OR ENVIRONMENTAL SERVICES
PROVIDE MUNICIPAL PROCESS NUMBER HERE
LOCATION OF
IMPROVEMENTS
Job Address ____________________________________________
Folio ___________________________________________________
Lot ____________________________ Block ___________________
Subdivision _________________________PBpg _______________
Metes and bounds _______________________________________
CONTRACTOR
INFORMATION
Contractor No. _______________________________
Last four (4) digits of Qualier No. _______________
Contractor Name _____________________________
Qualier Name _______________________________
Address _____________________________________
City _________________ State ____Zip ___________
TYPE OF
IMPROVEMENTS
[ ] New Construction on
Vacant Land
[ ] Alteration Interior
[ ] Alteration Exterior
[ ] Relocation of Structure
[ ] Enclosure
[ ] Repair
[ ] Repair Due to Fire
[ ] Demolish
[ ] Shell Only
[ ] Addition Attached
[ ] Addition Detached
[ ] Re-Roof
[ ] Foundation Only
[ ] Tent
Current use of property _______________________________
____________________________________________________
Description of Work __________________________________
____________________________________________________
Sq. Ft. ______________Units _________Floors ____________
Value of Work _______________________________________
PERMIT TYPE
[ ] MBLD*
Category ________
[ ] MELE ________
[ ] MPLU ________
[ ] MLPG ________
[ ] MMEC ________
[ ] FIRE ________
REVIEW STATUS
[ ] Chg. Contractor
[ ] Re-Issue
[ ] Re-Stamp
[ ] Revision
[ ] Not Applicable for
Fire
OWNER’S INFO
Owner _______________________________________
Address _____________________________________
City _________________ State ____Zip ___________
Phone _______________________________________
Last four (4) digits of
Owner’s Social Security No. ____________________
PERMIT
CONTACT
Name __________________________________________________
Address ________________________________________________
City ________________________State _____ Zip ______________
Phone __________________________________________________
ARCHITECT /
ENGINEER
Owner _______________________________________
Address _____________________________________
City _________________ State ____Zip ___________
Phone _______________________________________
FIRE SPECIAL
REQUEST PLAN
REVIEW (SRI)
I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as possible. There is a minimum charge of
one-hour. Please contact the Fire Department for current rate.
1
st
Request: ____________________________________________________________________ Date: __________________________
2
nd
Request:____________________________________________________________________ Date: __________________________
3
rd
Request: ____________________________________________________________________ Date: __________________________
If the applicant is a known named violator with: unpaid civil penalties; unpaid administrative costs
of hearing; unpaid County investigative, enforcement, testing, or monitoring costs; or unpaid liens,
any or all of which are owed to Miami-Dade County pursuant to the provisions of the Code of
Miami-Dade County, Florida, a hold on the review may be placed on this application.
123_01-192 4/23
PROPERTY