Building Construction Services
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
www.CharlotteCountyFL.gov
BuildingSvcs@CharlotteCountyFL.gov
”To exceed expectations in the delivery of public services”
A recorded Notice of Commencement is required in the Permitting Office prior to first inspection.
Application Date
Permit Number
2
For Office Use Only
0 0
CSR
Sept. 2006. cj
CONTRACTOR AFFIDAVIT
Form 5(d)
SEWER TEST
Signature of Contractor
Printed Name of Contractor
Owner Name
Subdivision
Street Name
Unit #
Tax Folio # Lot Block
Street Number
Street Type
Contractor Name
Contractor Phone # Contractor Fax # Contractor License #
Date
I certify that I , the undersigned contractor, have personnaly tested the Gravity Sewer to conform to
FPC Section 312.
FLORIDA PLUMBING CODE, SECTION 312, TESTS AND INSPECTIONS
Sewer Tests shall be provided by the licensed plumbing contractor. It shall be verified by an affidavit that shall be
posted at the water heater location at the time of final inspection for new construction, or with the building
permit for a replacement.
Start of Test
Time: _____________________
Finish of Test
Time: _____________________
