Fillable City of Virginia Beach (City of Virginia Beach)

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City of Virginia Beach (City of Virginia Beach)

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City of Virginia Beach
PL
ANNING/PERMITS & INSPECTIONS
(757) 385-4211
FAX (757) 385-5777
TDD (757) 385-4305
VBgov.com
2875 SABRE STREET, SUITE 500
VIRGINIA BEACH, VA 23452
POOL ENCLOSURE MODIFICATION
Permit #: Lot #:
Address:
As the owner of the property, I hereby request a modification in accordance with Section 106.3
of the Uniform Statewide Building Code (USBC). I ask that the requirements of Section 305.4
Sub- Section 1 of the International Swimming Pool and Spa Code (ISPSC) to install an alarm
to doors from the building wall (side/rear of the house) used as part of the pool enclosure be
waived.
All other requirements for enclosure of the pool shall be met and verified by field inspection
prior to occupancy and use of the pool.
By this request, I assume full responsibility and relieve the City of Virginia Beach of any
liability.
Signature of Property Owner Date
STATE OF:
CITY OF:
:TO-WIT:
I,
, a Notary Public in and for the aforesaid State hereby certify
that
appeared before me in the State and City aforesaid and
executed this affidavit on this day of
,
.
Notary Public
My Commission Expires the day of
,
.
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City of Virginia Beach (City of Virginia Beach)

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Completed 4 June 2021

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