In-ground Pool Permit - Division of Building Services
Applicant Please complete items 1-10
1
. _____________________________________________________________2.__________________________________________________________
Address (where the pool will be located) Name of Business OR indicate “private” if pool will be at a private residence
3.____________________________________________________________________________________________________________________________________
Legal Description or Property
4.____________________________________________________________________________________________________________________________________
Owner of Record (of property) Mailing Address, City, State, Zip Phone
5
.____________________________________________________________________________________________________________________________________
Licensed Pool Contractor Mailing Address, City, State, Zip Phone License #
6. Pool Checklist:
Pool Plans Site Plan Valuation (Labor & Materials) of pool $ _______________
Will a new fence be needed? Yes No If fence is existing: Height ______ Fence Material/Type: ____________________
Will plumbing or electrical work be performed in conjunction with this swimming pool installation? Yes No
Electrical Contractor Name __________________________ Plumbing Contractor Name ______________________________
7. Applicant’s Name___________________________ 8. Phone Number____________________
9. Applicant Represents:_______________________ 10. Applicant’s Email: _______________________________________
Applicant Please Read
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or
local law regulating construction or the performance of construction.
11. Signature of Applicant:_________________________________________________________ Date:________________
-----------------------------------------------------------------------------------Staff use only-----------------------------------------------------------------------------------
Application Accepted By:______________________________ Date:______________ Permit Number__________________
(Staff Signature)
General Conditions for Pool Approval would include, but are not limited to the following:
1. All electrical work associated with the pool is to be GFCI protected. The pool shall not be located within 22’ vertically or 10’ horizontally
from overhead electrical conductors. The pool may not be located within 10’ vertically or 10’ horizontally from overhead telephone or TV
cables. Measurements are from the water’s edge. This permit does not authorize any additional electrical or plumbing work to be
performed that is not directly related to the installation/construction of the pool.
2. Enclosure of pools: Every in-ground pool shall be completely enclosed by a solid fence or wall not less than six (6) feet in height. The
fence or wall cannot be constructed with features, which could be used for climbing over the fence or wall. Gates must be self-closing and
must have a latch or other mechanism, which shall engage automatically upon closing. Where the release mechanism of the self-latching
device is located less than 54 inches from the bottom of the gate, the release mechanism must be located on the poolside of the gate, 3
inches or more below the top of the gate. The gate and barrier must be constructed so there is no opening greater than a .5 inch within 18
inches of the release mechanism. Exception: The door of a dwelling, which opens onto a pool enclosure, must be equipped with an alarm.
3. Do not attach extension cords to pool equipment pigtail.
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