Universal Engineering Sciences 3532 Maggie Blvd., Orlando, FL 32811
Tel 407-581-8161 * Fax 407-581-0313 * www.universalengineering.com
APPLICATION FOR PLUMBING PERMIT
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
DATE OF APPLICATION: PERMIT NUMBER
The undersigned hereby applies for a permit to make plumbing installations as indicated below. PLEASE PRINT
Project Address , Belle Isle FL ___32809 ___32812
Property Owner Phone
Property Owner’s Mailing Address City
State____________ Zip Code _______________ Parcel Id Number: ____________________________________________________
To obtain this information, please visit http://www.ocpafl.org/Searches/ParcelSearch.aspx
Class of Building: Old New Type of Building: Residential Commercial Other
Type of Work: New Alteration Addition Repair Type of System: Sewer Septic Re-pipe
YOU MAY BE REQUIRED TO PROVIDE SEPTIC SYSTEM VERIFICATION FOR NEW / ALTERED / ADDITION
to Septic System – ORANGE COUNTY DOCUMENT 64E-6
VALUATION OF JOB (labor & materials) $
FIXTURES Quantity
FIXTURES Quantity
Water Closets (Toilet) Dishwashers
Bathtubs Laundry Tubs
Urinals Floor Drains
Disposals Grease Traps
Washing Machines Trailer Connections
Water Heaters Spa
Sewer Solar
Catch Basins/Sumps Pool Piping
Service Sink *Irrigation: (# Systems / # Heads)
Lavatory (Bathroom Sink) Water Softener
Showers Re-pipe
Sinks Miscellaneous (Specify)
*Per FBC, Sec. 608, a Backflow Preventer must be installed & tested; the report must be posted with permit for Final Inspection.
Review Fee
1% BCAIB Fee
1.5% DCA Fee
Total Permit Fee
I hereby certify that the above is true and correct to the best of my knowledge and make Application for Permit as outlined above, and if
same is granted I agree to conform to all Florida Building Code Regulations and City Ordinances regulating same and in accordance with plans
submitted. The issuance of this permit does not grant permission to violate any applicable Town and/or State of Florida codes and/or ordinances.
LICENSE HOLDER SIGNATURE LICENSE #
LICENSE HOLDER NAME COMPANY NAME
Street Address
City State Zip Code Phone Number
Email Address
NOTE: The Building Permit Number is required if the Plumbing Installation is associated with any construction or alteration where a Building
Permit has been issued.
Building Permit Number
Building Official:_____________________________ Date__________________
Verified Contractor’s Licenses & Insurance are on file __________ Date_________
click to sign
signature
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