Development
and / or
PLANNING AND DEVELOPMENT SERVICES
Mailing Address:
Building
th
453 West 12
Avenue, Vancouver BC V5Y 1V4
Application Form
tel: 604.873.7611
To help expedite submission of your application, please fill out BOTH sides of this information sheet prior to attending the Application Preview counter
located in the Development and Building Services Centre, Ground Floor, 515 West 10th Avenue (West Annex, City Hall).
JOB LOCATION
(Correct and complete addressing is important. Complete this section carefully.)
Address:
Specifics:
Floor Level:
Suite No:
Legal Description:
Lot(s)
Block(s)
District Lot(s)
Plan Number(s)
Are you aware of the presence of any contaminated soils on the subject property?
Yes
No
Are you aware of the existence of any contaminated soils studies, reports, soil agreements, or Ministry of Environment
orders or letters with respect to the subject property?
Yes
No
Is the building being converted to strata-title ownership?
Yes
No
Note: If you intend to convert an existing building to strata title ownership, please contact Subdivision and Strata Title
staff at 604.871.6627 for information on the strata conversion process in advance of the issuance of any permits.
This area must be completed by the person signing the application form
Your Name:
You are the:
01
Property Owner
Mailing Address:
02
Contractor
03
Certified Professional
City:
Postal Code:
04
Design Professional
05
Tenant
E-mail Address:
06
Agent for Owner
07
Agent for Tenant
Phone Number:
Fax Number:
08
Consultant
09
Non-profit Association
Company Name:
Cert. No:
10
Civic Department
Account
Business License
Number:
98
Other
Note: Contractors/design professionals/consultants MUST have a valid Business License to do work in the City of
Vancouver. You may obtain current business license account numbers from the Business License Counter.
Complete the following for ALL applications
Property Owner’s Name:
Address:
City:
Postal Code:
Phone Number:
No
Is the owner aware of this application?
Yes
Contractor’s Name:
Address:
City:
Phone Number:
Postal Code:
Business License Account Number:
Tenant’s Name:
City:
Address:
Postal Code:
Phone Number:
Job Contact:
City:
Address:
Postal Code:
Phone Number:
Qualified Professional Contact Name
(required for Salvage & Abatement):
City:
Postal Code:
Address:
Phone Number:
Business License Account Number:
Please continue application on reverse