Fillable Application for a Certified Model (City of Vaughan)

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Application for a Certified Model (City of Vaughan)

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Application for a Certified Model
Pursuant to the City of Vaughan Building By-law
Note: This Application for a Certified Model is a form prescribed by the Chief Building Official pursuant to the City of Vaughan Building By-law and must
be completed for each model. A certified model is NOT in itself a building permit. A Certified Model can only be used by the Builder in Section “C”.
For use by City of Vaughan
Certified Model Number:
Date received:
A. Project and Model Information
Builders Model Name:
Building Code Edition:
Latest O. Reg amendment #:
Type of Dwelling: Detached Dwelling □ Semi-Detached Dwelling □ Townhouse (Stacked TH not applicable) □
Office use: 001 □ 005 □ 010 □ 015 □
Elevation:
Elevation:
Elevation:
Options: (3 per Elevation)
# of Bedrooms
GFA (m
2
)
Alt. Floor Layout(s)
Basement Walk Out (Y/N)
Basement Walk Up (Y/N)
Basement Look Out (Y/N)
Basement (Finished) (Y/N)
Secondary Suite (Y/N)
Garage Option (Type)
Special Feature:
Deck (Y/N)
Side door entry (Y/N)
Other Details (_________)
Other Details (_________)
Other Details (_________)
Other Details (_________)
Limiting Distance (Left)
Limiting Distance (Right)
Limiting Distance (Rear)
Energy Efficiency (Pkg)
Work Description and Certified Model name previously assigned (if applicable):
B. Applicant Applicant is: Owner or Authorized agent of owner
(if the Applicant is a corporation or partnership, name the person applying on its behalf)
Last Name
First Name
Corporation or partnership
Street address
Unit number
Municipality
Postal code
P
r
o
v
i
n
c
e
Email
Telephone number
Fax
Cell
C. Builder
Registered Name of Builder
Contact
TARION
Reg. No.
Street address
Unit number
Municipality
Postal code
P
r
o
v
i
n
c
e
E-mail
Telephone number
Fax
Cell number
D. Declaration of Applicant
I
certify that:
(print name)
The information contained in this application, attached drawings and other documentation is true to the best of my
knowledge.
1.
Applicant is responsible for separate application of Repeats under the latest Ontario Regulation/amendments.
Date Signature of Applicant
Application for a Certified Model – August 22, 2018
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Application for a Certified Model (City of Vaughan)

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Completed 9 May 2021

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