SPECIAL EVENTS TEMPORARY STRUCTURE PERMIT AFFIDAVIT REQUEST
Date of Request:
Event Name:
Event Date(s):
Event Location(s) /Property Address:
Temporary Structures Installation (please list all structures and exact dimensions):
Set-Up Date:         Breakdown Date:
Name of Vendor and/or Qualifier (Licensed entity pulling the permit):
Contact Person:
Contact Number:

IMPORTANT: Please be aware that this affidavit request is only for Special Events held on public property. Please make sure that the information on this form is complete, if it is not our office we will not consider it. Once the affidavit is issued, you will be notified that it is ready for pick up. Please present the original affidavit to the Building Department in order to obtain a permit.

    
Physical address: 555 17th Street NE entrance, Miami Beach, Florida 33139 Ph: 305.673.7577 - Fax: 786.394.4558 - www.eventsmiamibeach.com