BP#______-______Balance Due:$______.____

City of Lemoore – Building Department

711 W. Cinnamon Drive, Lemoore, CA 93245 (559) 924-6730

Swimming Pool Permit Application

Application Date: ______

Applicant: ______Phone: ______

Job Site Address: ______

Owner Name: ______

Owner Address: ______

Work Description: ______

Commercial: ______Residential: ______Industrial: ______

Surface Area: ______

 POOL

 SPA

Valuation: _$______

______

Pool Contractor: ______

Address: ______

Phone: ______

State License Number: ______Exp.______

City Business License Number:______

PLAN SUBMITTAL FOR RESIDENTIAL / COMMERCIAL

 1 – ORIGINAL WETSTAMPED SETOF PLANS

 2 – COPIES OF ORIGINAL WET STAMP SET OF PLANS

OFFICE USE ONLY

 ACCEPTED – PLAN SUBMITTAL COMPLETE

 REJECTED – PLAN SUBMITTAL INCOMPLETE – See special Instructions

Special Instructions: ______