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00-1385-001 A roved Disapproved Fee Duet PP MIAMI-DADE COUNTY FIRE RESCUE REQUEST FOR R INSPECTION OR PLANS REVIEW Fire Dept. Application # 3 0�� 1 Date: Plan review type (Check all applicable boxes.) Occupancy Type: (Building permit only.) Building permit. (Check occupancy type.) ❑ Storage/Warehouse 0 Health Care ❑Fire Alarm permit. .. 0 Assembly (occ. 50+) 0 Industrial ❑ Sprinkler System permit. ❑ Board & Care 0 Special Structures ❑ Fire Supression Sytem ❑Business/Offices ❑ Lodging x ❑ Water Main Ext./Fire Hydrant permit. 0 Deten/Correction Q Mercantile/Retail 0 Other Permit 0 Apartments/Condo ❑ Hotel/Dormitory ❑Expired permit/Renewal. `'?0 Educational 0 Tents 0 Revision to a permit still in process. ❑ Revision to an existing permit. 0 Previously 0 Miami-Dade i- County or❑ Municipality: City of` -- inspection type requested (Circle all applicable t'pesj'Final C.O.; Preliminary; T.C.O.;•FireAlarm, Fire Pump Test;Re-inspection; Sprinkler/Standpipe; Other,. Please print all information clearly. Process number: ~- Permit number: Cost of contract: Square footage: ? No.Stories__: Project Name: bEL'L el b � �b E E S p0/�Jg Job Address:�/( _ S IU �j� M city: © ( 'T 1 State: Zip: . 3 f Scope of work: Contact Pe on: ny Name: Permit Relationship::-- Aao't" ��� ' (it,Applicant;Arch.;Eng.;Expeditor;Contractor.) Contact Address:, /9 City: V _r1 t /Yl P 9 1 State: EL.O RI Zip:') Contact Phone 1(3eS-) PSPhone 2(305 ) 6 6/9'6/U Fax#( 0 I am requesting a Special Request Inspection on the following date and time: I understand that the rate will be $75 per hour for each inspector with a minimum of 4 hours. I will need inspectors. Signature: ❑ I am requesting a Special Request Plans Review to be scheduled as soon as possible at the rate of$150 for the first hour and$50 per each additional hour. Minimum 1 hour charge. Signature: Received by: Entry Date: Assigned to: O.I.C.Approval For information call: Miami-Dade County Fire Rescue 305-375-2771 rev. 1/6/00