HomeMy WebLinkAboutAffidavit of Requirement CompliancePLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462.1553 Far(771)452-1578 RECEIVED
AFFIDAVIT OF REQUIREMENT comTLIAN CE
Residential Swimming Pools, Spa, and Hot Tub Safi ty Act FEH 27 120
PERMITN ST. Luau Guunty, Permitting
f We) acknowledge that a newswimmiog pool, spa, or hot tub will be constructed or installed at
ip3a Fn(:lav CIiP D and hereby affirm that one of the following methods
(Please printstreet address) -
will 6 to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool.)
The pool will be isolated from access to the home by an enclosure that meet$ the pool barrier requirements of Florida Statute 51529.
The pool will be equipped with an approved safety pool cover Unit complies with ASTM 171246-91(Stendard Performance Specifications for
Safety Covers for Swimming Pools, Spas, and Hat Tubs).
All doors and windows providing direct access from the home to the pool will be equipped with an exit alarm that has a minimum sound
pressure rating ofg5decibds at 10 feet
All doors providing direct accessfmm the home to the pool will be equipped with self closing, self latching devices with release mechanisms
aced no lower than 54 inches above the floor or deck.
in Pooi water harm aerfified fo fISTM stan&rd Faao8
I understand that not having one of the above installed at the time of final inspection, or when the pool is completed for contract
purposes, will constitute a violation of Chapter 515, F.S., and will be considered as committing a misdemeanor of the second degree,
punishable by fines up to.S500.00 and/or up to 60 days in jail as established in chapter 775, F.S.
I understand that the St. Lucie County Building Inspections Department assumes no liability for the final inspection of one of the
above protective devices, or the lack of mnintenance, or the removal of such after the swimming pool has been fsmlimd.
I, the contractor, agree to instruct the owner of the proper use and
The foregoing instrument was acknowledged before me
tbi0q(Adayof ILAQ042090
bySaWS 7
Personally Known cr Produced Identification
Type of Identification Produced:
RE
State of Florida
oSLCPDS Ravi¢on GG 262653
R022
of such safety device.
OWNER SIGNATURE
AT F FLORIDA, COUNTY OF � L L(CI'f
NOTARY PUBLIC
The foregoing instrument vials acknowledged before in,
this, day of r✓ r 2p�
by kOMGt_S MCI U l�'olZ S
Personally Known W or Produced (Identification ✓ ' n
Type of Identification produced: of wi fS 1
YE9
c State uoion GG3r2022
PERMIT It
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, FL34982
(772) 462-150 Fax (772) 462-1578 r—
AFFIDAVIT OF REQUIREMENT
Residential Swimming Pools, Spa, and Hot Tub gafety AaB ! 7 120
Permitting
(We)acknowled eth,,,I; wswimmiu
103 FnClav g CrI P g pool, spa, or hot tub will he constructed or installed at
and hereby affirm that one of the following methods
(Please print street address)
will br--UWA to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool.)
�
The pool will be isolated from access to the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29.
ST. Lucre
The pool will be equipped with an approved safety pool cover that complies with ASTM F1246-91(Standard Performance Specifications for
Safety Covers for Swimming Pools, Spas, and Not Tubs).
All doors and windows providing direct access from the home to the pool will be equipped with an exit alarm that has a minimum sound
Pressure rating of85decibds at 10 feet
ors providing direct access from time home to the pool will be equipped with selfclosing, self latching devices withrelease mechanisms
no lower than 54 inches above the floor or dccl:.
ool orate,►- Rbrm eerf>fied to flSTm standard Faao8
VMR;Eii;
t not having one of the above installed at the time of final inspection, or when the pool is completed for contract
stitute a violation of Chapter 515, F.S., end will be considered ns committing a misdemeanor of the second degree,
es up to 3500.00 and/or op to 60 days in Jail as established in chapter 775, F.S.
I understand that the St. Lucie County Building Inspections Department assumes no liability for the final inspection of one of the
above protective devices, or the lack of matntennncq or the removal of such after the swimming pool has been finalized.
1, the contractor, agree to instruct the owner of the proper use
r
The foregoing instrument was acknowledged before me
th?�(Adayof Q ZO� pO
by �.Ja MQ-S 'r
Personalty Known or Produced Identification
Type of Identification Produced:
REK
State of Florida
oSLCPDS Revkon GG 262653
/2022
of such safety device.
OWNER SIGNATURE
OF 5+ L'LtCl-t
NOTARY PUBLIC
The foregoing instrument was acknowledged before me
this Yl_m day of rJ 1"
by -rA-0 Ma S Ma
Personally Known W or Produced Identification ✓ ' 0
Type of Identification produced: 0(1 �i S 1ter%R