Swimming Pool Permit Application6161 Belmont Ave NE Belmont, MI 49306

616-364-1190

Job Location Information

Applicant

Type of Pool

Signature of Applicant

Application Date:

Swimming Pool Permit Fee: $40 + $6 per $1000 value

Performance Bond (Refundable):

$200

Name of Property Owner:

Street Address:

City : State: Zip:

Lo __ Homeowner Contractor If you are a contractor, please fill out the following information:

Contractor Name: Expires:

Address:

City: State: Zip:

Phone: Cell: E-Mail:

License #:

Above Ground: Sidewall Height in Inches: _________ Minimum Depth ___________ Maximum Depth ___________ In Ground: Length x Width: __________ Minimum Depth __________ Maximum Depth __________ Soft Side: Sidewall height of pool in inches: __________

Construction Type: Cement Metal Plastic Other _____________________

Value of Project: $______________________

Pool water discharge must be contained on-site.

Decks require a separate building permit with a site plan, detailed prints, and gate/barrier information.

Name (Signature) Date:

Name (Printed)

New pools may NOT be used until a final inspection has been done to insure all codes and compliances are correct and written notice of final approval is issued.

This application must be accompanied by 2 sets of construction drawings and a site plan. This application will not be reviewed unless complete. Once the permit has been issued, contact the Community Development department to schedule the required inspections 616-364-1190. You will be notified via email when your permit has been approved.

In ground pools and pools with less than 48” sidewalls require a separate barricade or fence.

Type of Fence (Material): ________________

Email Address:

Phone:

*Note: Separate applications for electrical and mechanical permits are required and must be pulled throughCascade Township. www.cascadetwp.com 616-949-3765

revised Jan 2019

PLAINFIELD CHARTER TOWNSHIP COMMUNITY DEVELOPMENT DEPARTMENT

PLANNING, ZONING & BUILDING SERVICES6161 BELMONT AVENUE NE BELMONT, MI 49306 PHONE 616-364-1190

PERFORMANCE BOND FOR SWIMMING POOL INSTALLATION

DATE_________________ DEPOSIT AMOUNT:_________________ INVOICE #_______________

PAYEE NAME:____________________________________________________________________________________________

ADDRESS: _________________________________________________________________________________________

_________________________________________________________________________________________

JOB LOCATION: ____________________________________________________________PERMIT #_______________

JOB DESCRIPTION: __________________________________________________________________________________

SIGNATURE OF PAYEE:_____________________________________________________ DATE _____________________

Deposit will be returned to the payee listed above upon proper inspection and final approval of swimming pool installation.

BOND WILL BE FORFEITED IF THE ABOVE IS NOT COMPLETE

Date approved: ________________________________

Inspected By: _________________________________

Bond number: ______________________________

Date of refund: ______________________________

Check number: ______________________________ Date of Inspection: _____________________________

OFFICE USE ONLY:

$200.00

Notes: ____________________________________________________________________________________________

Authorized Personnel:_______________________________________________________________________________

revised January 2020