Fillable Application for Construction Permit (Island Health)

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Application for Construction Permit (Island Health)

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Application for Construction Permit
pursuant to the Pool Regulation
V1_R1 July 2013 Application for Construction Permit Page 1 of 5
Information Requirements supporting the Application for Construction Permit
Pursuant to the Pool Regulation, the person applying for the construction permit shall ensure the
attached Pool Information Sheets are duly completed by the project design professionals. Design
professionals are design architects who are registered or licensed under the Architects Act and/or the
design engineers who are registered or licensed as a professional engineer under the Engineers and
Geoscientists Act. The Pool Information Sheets will be considered as statements of fact to support
the health officer’s evaluation and decision to issue a construction permit under the Pool Regulation
s.5(3).
The person applying for the construction permit shall ensure that all related plans and specifications
for the construction as prepared, sealed and certified by an architect or engineer are submitted with
this application package. A person must not construct the pool other than in accordance with the
plans and specifications submitted with this application, unless prior written approval is obtained from
a health officer.
The Pool Owner, or their authorized agent, must sign the declaration in this Application for
Construction Permit, confirming the pool will be constructed in accordance with the plans and
specifications accompanying this Application for Construction Permit.
Additional note – Operating Permit Requirements. Once constructed, an operating permit will be
required prior to operating the pool. As part of the information package supporting the application for
an operating permit, a signed statement from an engineer or architect must be submitted confirming
that the pool has been constructed so as to substantially comply, in all material respects, with the
plans and specifications submitted in support of this Application for Construction Permit.
Application for Construction Permit
Application Form
V1_R1 July 2013 Application for Construction Permit Page 2 of 5
Application To:
Name of Pool
Date (dd/mm/yyyy)
Street Address
Contact Information: Owner or Agent
Name
Address
Phone Number
Email
Contact Information: Person Applying for Construction Permit (if different from Owner)
Name
Address
Phone Number
Email
Owner’s Confirmation of Commitment
I, _____________________________________ as owner of the above noted pool, confirm that it will
be constructed in accordance with the information contained herein and according to the plans and
specifications submitted with this Application for Construction Permit. No changes to the pool plans
and specifications will be made unless they have been authorized in writing by the design professional
and with written approval from a health officer.
Furthermore, I understand that upon completion of the pool’s construction, I must provide the
___________Health Authority with the following documentation before an Operating Permit for the pool
can be considered:
A signed statement from an engineer or architect that the pool has been constructed so as to
substantially comply, in all material respects, with the plans and specifications submitted under this
Application for Construction Permit.
A copy of a completed Swimming Pool Data Sheet providing detail of the pool as constructed.
A copy of the pool safety plan prepared in accordance with s.13 of the Pool Regulation.
Signature of Owner or Authorized Agent
Date (dd/mm/yyyy)
click to sign
signature
click to edit
Application for Construction Permit
Pool Information Sheets
V1_R1 July 2013 Application for Construction Permit Page 3 of 5
General Information
Name of Pool:
Civic Address:
POOL TYPE:
Public Pool Commercial Pool Hot Tub Spray Pool Wading Pool
Indoor:
Outdoor:
Owner Information
Name (Legal Corporate):
Address:
Phone Number: Email:
Designer Information (Append additional information for multiple designers):
Name: PEng:
Arch:
Company (Legal Corporate):
Address:
Phone Number: Email:
General Pool Design Parameters (Append additional information for multiple pools):
Pool Volume: (m
3
) Turnover: (hours) Design Re-circulation Flow Rate: (L/sec)
AREAS: (m
2
)
Pool: Deck:
WATER DEPTH: (m)
Min. Max.
MAX BATHING
LOAD:
Shallow: Deep: Total:
POOL BASIN
COLOUR:
Colour: Complies with Pool Regulation Y N
FILTERS:
Sand D.E. Pressure Vacuum Gravity NSF Approved Y N
GAUGES (Qty):
Pressure Vacuum Temperature
FLOW
INDICATOR:
Make & Model
RANGE: (L/sec)
From: To:
DISINFECTION:
Hypochlorite Chlorine Gas Stabilized Chlorine Bromine Other
Application for Construction Permit
Pool Information Sheets
V1_R1 July 2013 Application for Construction Permit Page 4 of 5
Health Hazard Related Design Parameter
Reference to Pool Regulation (PR) and B.C. Guidelines for Swimming Pool Design (GSPD)
Design
Parameter
Met
Initials
The plans include a fence or other barrier around the pool and its walkways with controlled
access to prevent access by animals and persons who are not pool patrons. This provision
does not apply to spray pools or wading pools that are planned to be drained before dark
and left empty overnight. PR s.(7)
Y N
n/a
The pool design provides for the pool water to be maintained at a temperature of no more
than 37°C.
PR s.10(2)(b)
Y N
Disinfection equipment is designed to be capable of maintaining disinfection levels in
accordance with the Pool Regulation
PR s.10(2)(f) & s.10(2)(g) & Schedule 3, s.1(2)
Y N
The pool circulation system is designed so that pool water will not pass through any drain
grate at a speed greater than 46 cm per second when the pool is operating at the design
flow rate.
PR s.10(2)(k) or waiver obtained under s.10(3)
Y N
The pool design allows for water to be circulated through the skimmers or gutters at a rate
of flow at least equal to 50% of the design flow rate.
PR s.10(2)(j)
Y N
The pool circulation system is designed so the water circulation rate (pool turnover) will
substantially comply with the GSPD.
GSPD – General Circulation Requirements
Y N
The pool design substantially complies with the Pool Regulation and the GSPD for the
prevention of entrapment or suction hazards.
PR s.10(2)(k) or waiver obtained under s.10(3); GSPD –
Suction Entrapment Hazards
Y N
The pool design allows for sufficient lighting so that all areas are visible to pool patrons,
lifeguards, and operators.
PR s.11(2)(a) ; GSPD - Lighting
Y N
n/a
All pool aprons, walkways and floors have a surface that is slip-resistant when wet, and
slopes away from the pool such that, when the aprons, walkways and floors are wet, water
does not accumulate or flow back into the pool
PR s.11(2)(c)
The friction coefficient of tiled surfaces specified for installation in and around the pool is
________ (static/dynamic), and will meet best practice guidelines referenced in the GSPD
with respect to being non-slip when wet.
GSPD – Surfaces and other Deck Considerations
Y N
The design requires that the nose of any step or ledge in the pool is marked in a contrasting
colour to the remainder of the step or ledge
PR s.11(2)d
Y N
The design provides for secure handrails at steps, ladders and diving boards. PR s.11(2)(e) Y N
The design includes pool depth markings in accordance with the requirement of the Pool
Regulation
PR s.11(2)(f)
Y N
Application for Construction Permit
Pool Information Sheets
V1_R1 July 2013 Application for Construction Permit Page 5 of 5
Health Hazard Related Design Parameter
Reference to Pool Regulation (PR) and B.C. Guidelines for Swimming Pool Design (GSPD)
Design
Parameter
Met
Initials
The design includes controls that will allow for regulating hot water temperature in pool
facilities to no more than 49
o
C. PR s.11(2)(g)
Y N
The pool design provides for, where applicable, hot tub water to be maintained at a
temperature of no more than 40°C.
PR s.16(b)
Y N
n/a
The filters are designed to provide proper filtration of the water at maximum flow rates as
per the GSPD.
GSPD - Filtration
Y N
The design incorporates a pool basin surface, that when filled with water, will be light in
colour and have a light reflectance value of at least 60%, measured according to ASTM
C609-07 standard to substantially comply with the Pool Regulation and the GSPD.
PR s.3(a);
GSPD – Pool Basin
Y N
All diving boards and poolside play equipment are designed and located in accordance with
applicable standards referenced in the GSPD.
GSPD – Play Equipment
Y N
Backflow preventers are provided in all areas necessary to prevent cross contamination
between the potable water supply, pool water and wastewater lines.
GSPD – Cross Connection
Control (AWWA Canadian Cross Connection Control Manual)
Y N
Design Professionals
The design professional responsible for each component noted in the Health Hazard Related Design Parameter Checklist
above shall initial applicable row(s) as a confirmation to a statement of fact and fill in the information in the table below.
Design Professional Name Engineer or
Architect
Company Initial
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Application for Construction Permit (Island Health)

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Completed 25 November 2020

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