What does the pool safety features form identify?

It lets the permit applicant identify at least two selected drowning prevention safety features for a swimming pool or spa at a private single-family home.

When is this form used?

The form applies when a building permit is issued for construction of a new pool or spa, or remodeling an existing one, at a private single-family home.

Loomis, CA · Placer County

No notary required

Applicant Identification of Selected Drowning Protection Safety Features for Swimming Pools and Spas

Pool permit applicants use this form to identify selected drowning prevention safety features and certify that they provided the information to the consumer.

What this form is

Use this form when applying for a permit to construct a new swimming pool or spa, or remodel an existing one, at a private single-family home. The applicant identifies at least two of the listed safety features and certifies that the consumer received the information. The form also notes that safety requirements must be installed before a pre-plaster inspection and includes a signature and date line.

Who needs it

A permit applicant for construction or remodeling work on a swimming pool or spa at a private single-family home should complete this form.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This document is signed without a notary; the applicant signs and dates the certification.

How to submit this form

1
Download the Form
Download the pool safety features form for your private single-family home project.
2
Identify Safety Features
Select at least two of the listed drowning prevention safety features.
3
Sign and Date
Sign and date the certification that you provided the information to the consumer.
4
Submit to the City
Submit the completed form to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What does the pool safety features form identify?: It lets the permit applicant identify at least two selected drowning prevention safety features for a swimming pool or spa at a private single-family home.
When is this form used?: The form applies when a building permit is issued for construction of a new pool or spa, or remodeling an existing one, at a private single-family home.
Do I need a notary for the pool safety features form?: No. This document is signed without a notary; the applicant signs and dates the certification.
How do I submit the pool safety features form?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Applicant Identification of Selected Drowning Protection Safety Features for Swimming Pools and Spas doesn’t need a notary — but if you have another Loomis form that does, a commissioned online notary can help.