BLD_Gas_Pressue_Test

Alachua County Board of County Commissioners

Department of Growth Management

10 SW 2ⁿᵈ Ave., Gainesville, FL 32601

Website: https://growth-management.alachuacounty.us

Submit Questions to: Building Division Tel. 352.374.5243

Affidavit must be completed, dated after work begins, and uploaded to permit at time of inspection. Failure to have affidavit completed at final inspection will result in a failed with fee result. Multiple affidavits may be required depending on scope of work.

Permit Number

Jobsite Address

Contractor DBA Name

Contractor Business Address

State

Zip

Contractor Phone Number

phoneFormat: (000) 000-0000.

Contractor Email

example@example.com

Name of Florida Gas Contractor

State License Number

Gas type (NG LPG)

Test Medium Used

Piping Material Used

Test Method Used

Pressure indicated at first reading

Time

Pressure indicated at final reading

Time

Per FBC R G2417.4.2 and FBC FG406.4.2, test duration shall not be less than 10 minutes.

Printed Name

I (name)

have personally performed or supervised the installation of the project listed on this form and attest that all work has been performed in accordance with the requirements of the Florida Building Code Residential, chapter 24 Fuel Gas. I personally performed the test above and certify that the information is correct and the test was performed in accordance with the Florida Building Code Residential section G2417 or Florida Building Code Fuel Gas section 406.

Printed Name

Date and Time work inspected

MonthDayYear

Hour MinutesAM/PM Option

Signature:

License Number

Once completed, please upload this form to your permits documents folder. This form may only be completed by a Florida Licensed Plumbing Contractor or LP Gas Contractor as defined in Florida Statutes Chapters 489 or 527.

Pressure Test Affidavit for Natural Gas or LPG