CITY OF FULSHEAR DEVELOPMENT SERVICES PO Box 279 / 29255 FM 1093 #12C Fulshear, Texas 77441 Phone: 281-346-8860 ~ Fax: 281-346-8237 www.fulsheartexas.gov SWIMMING POOL PERMIT APPLICATION Date of Application: Permit #: - Property Address: Legal Property Owner: Owner’s Address/City/State/Zip: Owner’s Phone Number: Contractor’s Name: Address/City/State/Zip: Contact Person: Phone Number: Email: Fee: $950.00 Flat Fee Breakdown: $100.00 Plan review fee due at time of submittal $850.00 Due upon approval Notes: • The application is non-transferrable. • Work must be started within 180 days of permit issuance date or such permit will be null and void. • Work without a permit posted could result in additional fees, work performed without a permit contractor will be assessed a $350.00 fine plus the cost of the permit. • Re-inspection fees must be paid prior to re-inspection at a cost of $60.00 I hereby accept all the above conditions and certify that all statements herein recorded by me are true. Contractor’s Printed Name Contractor’s Signature Date
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SWIMMING POOL PERMIT APPLICATION - Fulshear, Texas
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CITY OF FULSHEAR
DEVELOPMENT SERVICES PO Box 279 / 29255 FM 1093 #12C
Fulshear, Texas 77441
Phone: 281-346-8860 ~ Fax: 281-346-8237
www.fulsheartexas.gov
SWIMMING POOL PERMIT APPLICATION
Date of Application: Permit #: -
Property Address:
Legal Property Owner:
Owner’s Address/City/State/Zip:
Owner’s Phone Number:
Contractor’s Name:
Address/City/State/Zip:
Contact Person:
Phone Number: Email:
Fee: $950.00 Flat Fee Breakdown:
$100.00 Plan review fee due at time of submittal
$850.00 Due upon approval
Notes:
• The application is non-transferrable.
• Work must be started within 180 days of permit issuance date or such permit will be null and void.
• Work without a permit posted could result in additional fees, work performed without a
permit contractor will be assessed a $350.00 fine plus the cost of the permit.
• Re-inspection fees must be paid prior to re-inspection at a cost of $60.00
I hereby accept all the above conditions and certify that all statements herein recorded by me
are true.
Contractor’s Printed Name Contractor’s Signature Date
DEVELOPMENT SERVICES PO Box 279 / 29255 FM 1093 #12C
Fulshear, Texas 77441
Phone: 281-346-8860 ~ Fax: 281-346-8237
www.fulsheartexas.gov
Certification of House – Pool Protection Device Installation
I certify that I am the homeowner at:
warning when the door and its screen, if present, are opened. The alarm shall sound continuously for a minimum
of 30 seconds immediately after the door is opened and be capable of being heard throughout the house during
normal household activities. The alarm shall automatically reset under all conditions. The alarm system shall be
equipped with a manual means, such as a touchpad or switch, to temporarily deactivate the alarm for a single
opening. Such deactivation shall last for not more than 15 seconds. The deactivation switch(es) shall be located
at least 54 inches above the threshold of the door.
Printed name of the Homeowner:
Signature of the Homeowner: _ Date:
Notary Public to Complete the Remainder of Form
State of Texas
County of
BEFORE ME, the undersigned authority, on this day of in the year of ,
personally appeared , known to me to be a credible person and the signer
on the foregoing certificate, and who, after being by me duly sworn, did upon his/her oath, state that information
contained in such application is true and correct to the best of his/her knowledge and belief.
Notary Public in and for County
Notary Seal: State of Texas
My commission expires:
Texas Penal Code Section 37.10 states that a person commits a Class A misdemeanor if they knowingly make false entries in, or false alteration of, a governmental record or makes or uses any record document, or thing with knowledge of its falsity and with intent that it be taken as a genuine government record.
All doors with direct access to the pool shall be equipped with an alarm which produces an audible1.
with direct access to the pool area.
(print address) and the following swimming pool barrier protection devices has been installed between all doors