Plumbing Permit Application at a glance
What it is: The Plumbing Permit Application of the Department of Urban Planning and Redevelopment, Building Code Services Division.
Who signs: Sign on Signature, for the Owner or Agent (including Contractor) and for the Qualifier.
A filled-in Plumbing Permit Application example: a homeowner replaces a water heater
How to fill out Plumbing Permit Application, box by box
Permit number, folio, zone, lot, block and subdivision
Fill in the Permit #, the Folio # and the Zone, then the Lot, the Block and the Subdivision.
Type of Work
Under Type of Work, mark Addition, Alteration, New, Repair or Demolition, then write the work under Describe.
Purpose and Estimated Job Value
Under Purpose, mark Sub-Permit, Water Services, Backflow Installation, Backflow Recertification, Water Heaters, Irrigation System, Sewer Hookup, Gas, Fire Sprinkler or Other, and write the Other.
Write the Estimated Job Value.
Job Name and address
Write the Job Name, the Address, the City and the ZIP Code.
Owner's Name
Under Owner's Name, write the name, the Address, the City, the ZIP Code and the Phone.
Contracting Firm
Under Contracting Firm, write the firm, the Address, the City, the ZIP Code, the Phone, the Cellular Phone Number and the Fax Number.
Architect/Engineer
Under Architect/Engineer, write the Architect/Engineer, the Address, the City, the ZIP Code and the Phone.
Present Use, Proposed Use and Number of
Write the Present Use and the Proposed Use, then under Number of write the Stories, Bays, Families, Bedrooms and Bathrooms.
Bonding Company
Under Bonding Company, write the company, the Address, the City, the ZIP Code and the Phone.
Mortgage Lender's Name
Under Mortgage Lender's Name, write the name, the Address, the City, the ZIP Code and the Phone.
Fee Simple Titleholder's Name
Under Fee Simple Titleholder's Name, write the name, the Address, the City, the ZIP Code and the Phone.
Signature, Printed Name and Date
Application is hereby made to obtain a permit to do the work and installations as indicated.
By signing you certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in Broward County, Florida.
Owner's affidavit: by signing you certify that all the information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning.
Warning to the owner: failure to record a Notice of Commencement may result in your paying twice for improvements to your property; if you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement.
Write the Printed Name and the Date of the Owner and of the Qualifier.
NOTARY as to Owner and as to Qualifier
The NOTARY as to Owner and the NOTARY as to Qualifier each fill in My Commission Expires.
Certificate of Competency Holder
For the Certificate of Competency Holder, write the State Certificate or Registration No. and the Certificate of Competency No.
Application Issued by
Application Issued by is signed off by the Permit Officer.
More rules for Plumbing Permit Application
The 2004 Florida Building Code is in effect.
A separate permit must be secured for structural, electrical work, signs, wells, pools, furnaces, boilers, heaters, tanks and air conditioners, etc..
In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies or federal agencies.
Sources
[1] Plumbing Permit Application, Form 503-147 (Rev. 10/04), Department of Urban Planning and Redevelopment, Building Code Services Division (the Official source link on this page).