HomeMy WebLinkAboutAffidavit of Requirement CompliancePLANNING & DEVELOPMENT SERVICES DEPARTMENT
Buildin and Code Reulations Division RECEW
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2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax(772)462-1578
- FEg. 0 6 IS
Permittin 0i0 e a ment
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AFFIDAVIT OF REQUIREMENT COMPLIANCE St,
Residential Swimming Pools, Spa, and Hot Tub Safety Act
PF.RAETN D'Vua m5LA
I e) ackno edge that a �ntew swimming pool, spa, or hot tub will be constructed or installed at
xQ ��P n J . and hereby affirm that one of the following methods
(Please print street address)
will be used to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool.)
t tl— The pool will be isolated from access to the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29.
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 Hot Tubs).
I 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 of 85declbels at 10 feet
All doors providing direct access from the home to the pool will be equipped with self closing, self latching devices with release mechanisms
placed no lower than 54 inches above the floor or deck
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 $500.00 and/or up to 60 days in jail as established in chapter 775, F.S.
I understand that the St. Lucie County Building Inspections Department assumes no liability for the final inspection of one of the
above protective devices, or the lack of maintenance; or the removal of such after the swimming pool has been finalized.
I, the contractor, agree to
I
The foregoing
the owner of the proper use and maintenance of such safety device.
1
was acknowledged before me
this ,day of R4 , 20��
byy�.y i•�,.wQQ �i�.
Personally Known L or Produced Identification
Type of Identification Produced:
SLCPDS Revised 07/122014 �0 Notary Pudic State of Florida
Sabrina M Arrington
+a- My Commission GG aoa279
p Expima 08/27/2023
STATE OF O ) COf1NTY OF % % �� "F5
Y P \ NOT [C
The foregoing instrument was acknowledged before me
this ,_day ofl�-�{'� .20—rat
by
Personally Known or Produced Identification
Type of Identification produced: ' L�
R19
tets ringtn GGo23
POOLS
GREG,
INC.
Name _E/
Legal Descrfpt
Owner Mailing
Contract Pnce ($
BASIC POOL:
SPA649&A76�
INTERIOR FINIS
8886 S. FEDERAL HWY. _
PORT ST. LUCIE, FL 34952
PHONE: (772) 337-9713 • FAX: (772) 337-9287
www.poolsbygreginc.com
CPC 1458338
CONTRACT
FOR POOL CONSTRUCTION
Dept.
Price Good
;Z?Z S/y 7 5y 2
-77Z"Zal'?jgoo
Size/Shape: ((y rt, rC 3n 1%mt/) Ste7 Steps: Swim Out: Z
Depth Shallow End:%r' Depth Deep End:
Ladder: Ate)Handrail: A!d Misc.: A0
606 Tile:
Cap: _
Step Tile:
DECK Materiat,fn�A/c2v.-rg-
Color.
Size: pist-nt
Existir
Deck O Drain: Prue_ n t-A, ,
FILTER:
I;M
Waterfall / f
"Mosaics:
POOL BUILDER MAY CHANGE
PATIO SURFACE TO SPRAY
Pump: that rrA4e /Af
ref U r`P? J Size: .'3,/T egfo DECK IF NECESSARY
EQUIPMENT. Safety Fence Color:
Fill Water. City �,�,,r�-+��•ielrw ess. Tank
Chlorinator. /r[1
/APcol Cleaner. 0,a&.42- ,—StDt1%Flter/Valved:
Heater. Size:: /MIQ
0T12A-z9A1P/CTank: /Vo Valuing for Future Heater: '
Vacuum Set Incl. lmaee%W,; handle, brush, Test Kit & Instruction, I)a ;
Main Drain:32,/y GHF,»vei,
Inlet(Returnfittings): f [�Skimmer(s):
/ Underwater Ught(s):
2. - [n(,o 60 v rig 300W, 12 Volt — 100W, 12 Volt
` Transformer: /
Junction Box s : / Timers: /
Disposition of Fill: LEAVE LEAVE & SPREAD r � MOVE AND SPREAD HAUL
Plans and permit by. Pools by Greg, Inc.
Entrance to pool site and elevation of pool as per approved plans.
ELECTRIC DONE BY: [/D()13D /p.1l%
—�
72M Include in this contract: Alt)
SCREEN DONE BY:
Pfr`1 n/-RHn_ ,a ' 7 include in this contract: AAf7
SOLAR DONE BY:
M3 Arc- Include in this contract: A/`6
CUT & CAP SPRINKLERS DONE BY.,
ello At-r= include in this contract: Apr)
OTHER EQUIPMENT/CONSTRUCTION: AWrnryt. te,w) d,;e-An)t/A,�_,QwTwrn.AsRYKTiAIr,-
CHANGE ORDERS: There will be an additional charge to purchaser of $45.00 for any change orders, plus additional charge for
whatever changes order consists of. See reverse side of contract for details.
WARRANTY: In order to validate the warranty on the reverse side of this Contract, a monthly test of a sample of the pool water must
be done for a 1 year period by a qualified swimming pool chemical store. Please see item (4) under limited warranty on the reverse
side of this Contract for details.
CONSTRUCTION: No finish grading, planting, sodding or seeding shall be done by Pools by Greg, Inc., and any trees or other
planting to be saved shall be removed, cared for, and replanted by the owner. The removal and / or replacement by this contractor
of KNOWN obstructions shall be limited to the following:
HOMEOWNER'S ASSOCIgTION REQUIREMENTS AND APPROVAL SHALL BE THE RESPO�N7SIBILITY OF THE OWNER.
• Preparation Fee $ � �8 , 06 �% Patio $ 02,1 t, - -26 L_%
Shell Draw $ 2 F, _3g $, 00 .So % Completion: $ 7.7 30 . 7,5-
Plumbing, (Filter $ /Z9 9fif, r O 3D % TOTAL OF
at Completion) ' THIS CONTRACT $ SY ?75`r t7�
Contract to be financed through: 1f1111]ap"ky
Pools by Greg, Inc cannot be hold rwb;asible for any loss, damage, death or Injury due to malfunction of safety barrier when used by the customer,
for any reason beyond its control, under any cimumstances, for any reason whatsoever. The customer assumes all risks directly or Indirectly, related to
malfunctioning, failure, or Improper use of alarm barter. Keep all grates and drain covers In the pool and/or spa In good repair and secured in place.
Mort as swimmers to stay away from these devices, w the suction from drain outlets Is strong enough to cause entrapment of hair or body parts, and
drowning. Children using pool/spa must always have Vase adult supervision.
The undersigned owner or owner's agent, by affixing his signature hereto, hereby acknowledges that he has read, understands, and consents to
the conditions set forth on the revorse side of this contract.
I or we agree to pay a monthly finance charge of 1 A % (18% Annual Percentage Rate) on all past due bills.
Owner(s) hereb acknowledge receipt at the time of execution of this contract of an exact copy hereof.
Date: /uC.-.��- �� �� Builder:
Salesman: Owner.
Approved by Office: Own ._)f0�il�-- �llitQln
Non-refundable
'• Mosaics purchased outside of pool contract are the sole responsibility of the buyer to be installed before piaster.`
(See reverse side for Conditions of the Contract)
THE MOST EFFICIENT SINGLE CARTRIDGE FILTER EVER
The Clean & Clear RP filter gives you everything you could ask
for in a filter. This design is nearly 50% more efficient than most
single cartridge filter on the market. At the same time, it delivers
top -of -the -line cartridge performance to keep your pool sparkling
clear. Plus, cleaning is a breeze —its quick -connect ring makes
maintenance a cinch —just open the top, remove the cartridge,
hose it off and the Clean & Clear RP filter is ready to go again.
WK
The Clean & Clear RP filter has an innovative side entry port to
optimize flow and energy efficiency. And inside, we've maximized
the cartridge surface consistency to block and trap particles as
small as 20 microns. An average grain of beach sand is 1,000
microns!) Plus, its durable, fiberglass -reinforced tank helps to
ensure exceptionally long life.
• Unmatched hydraulic efficiency —nearly 50% more
energy efficient than other single cartridge filters.
• Quick -connect union with diamond seal assures easy installation
and servicing.
• Single -piece base and tank are constructed of fiberglass -
reinforced polypropylene for strength and chemical resistance.
• High FlowTN Manual Air Relief Valve and continuous internal air
relief work together to maintain optimum f ittration efficiency.
`T IED
Eco ; WAR-0 8 2020
ems` j ST. Lucle County, Permitting
�PENTAIR
AN ECD SELECT' BRAND PRODUCT
The Clean & Clear RP cartridge filter has earned
the Eco Select brand distinction Imm Pentair for its
efficiency and environmentally friendly performance.
pentairpooLcom
CCRP 150 150 76" 1 5.5" 150 72,000_Y 90,000 I 1088,000
�T CCRP 200 200 15.5" 150 72000 90 000non
' Required clearance to remove filter elements
EFFICIENT AND CAREFREE... BY DESIGN
The Clean & Clear as filter's innovative side entry design
optimizes flow for greater energy efficiency. It features an easily -
cleaned cartridge for the ultimate in carefree pool filtration. The
fiberglass -reinforced tank halves are secured with a low -force
clamp ring —just loosen the ring and remove the top half for easier
cartridge access and rinsing. Filter maintenance doesn't get
any easier.
AVAILABLE FROM:
PENTAIR
• 1112" drain cap and washout for quick and convenient
maintenance and winterization.
• Innovative lock -ring requires only an easy half of a
revolution fora teak -proof seal.
• Single -piece base and body designed for maximum
durability.
• Cartridge is easier to remove and rinse for near
effortless cleaning.
1620 HAWKINS AVE. SANFORD. NC 27330 800.831.7133 WWW.PENTAIRPOOL.COM
All Pentair trademarks and logos are owned by Pentair or one of its global affiliates. Clean & Clear'", High Flow'" and Eco SetecO am trademarks and/or registered trademarks of Pentair Water Pool and Spa, Inc.
and/or its affiliated companies in the United States and/or other countries. Because we are cominuously i nima, ug our products and services, Pentair reserves the right to change specifications without prior notice.
Pentair is an equal opportunity employer
pumps • filters • heaters • heat pumps' automation • lighting • cleaners • sanitizers • water features • maintenance products
4/17 Part # P1-109 02017 Pentair Water Pool and Spa, Inc. All rights reserved.
0
Techko USA - ALARM PROTECTION PRODUCTS - MODEL: S 187D
Page '1 of 1
TECIM-
MAR p J 2920
(2zality 5e[whr,fntzgriy,[otremitmetlttvfxwCence ST.Luciecc t PermlEting 'Print P0.isa'-Wind]
• Model: SW70• SAFE POOL
m Magheeticsensor entry alarm
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'Always an' alarn protection
{<<
R
Adult pass -through auto reset button
{
n" r
P-
Hlgh output 110.115 d6 alarm
r
WaterAveather resistant housing
s
b-
Magnetic sensor for additional door/screen door
Low battery LED display
Addtional pass -through button fordelayed entry from either side door or
—•
fence
P*
Additional magnetic sensor forsemen door eWentry
CONTAINER:
2D FT: 9,600 lies.
Jw-
Intended for Interior orwdedoruse
40 Fr: 19,680 pcs.
tw
9v battery operation (not Included_
40 HQ 22,898 pea.
A
UPC Baicoda: Of4575 187011
Q
Pool Guard Alarn USA Patent No. 5,473,310 and No. 6.727.819
e
EfL Approved underUL 2017 Standards 1
www.fechkomaid.corn i Office Products i Security Products
MAR 0 9 2020
ST. Lucie CouotY
for use in swimming pools only
The majority of daily heat lass Is due to evapomiian Solawill
minimises heat Ion by forming an ultro-thia, invisible harrier
on the mrfam of the water to reduce evaporation Its patented
psemmmre scheme ddlrny, systrm gmdua0y releases the formula into
the filtrating Were to allow for optimum cavemga One capsule
mean a 30,000 gollan pool for one month. Replace when necessary
to maintain water lemperaturs.
SolurPlll ran he used with all types of sanitiren and ismmpoUble
with all pool chemiary. For beg remlls, angle the returns downward
to decrease water surface movement, as SolorPill is most effective
in giU eager. Uneven distribution or use in water below 65°F may
produce resident which should dimppear in a few days.
DIRECTIONS FOR USE
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L inner W. ptenin9 .at We large name, hot,.
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hen fnml, o9gng hard wdom and predict is
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Run the "p mr ul Dave 0 bran daAA Oropeal tm un w m 3gpaa 9vOa nc
CAUTION: MILD EYE IRRITANT
Avoid motors will, eyes. Do not swallow. Wash hands Ihomughly
after handling. Um only in a well-veralated arm. Keep mntainer
eared. KEEP OIST OF RUCH OF CHILDREN.
FIRST AID:
In rose of sen contest: Wash with snap and water. If mist, are
Inhaled: Supply fresh air. If In oyes: Remove soared [am ifwom,
and duce opened eye for several veinalas under running water. Seek
medtmI wentwnfor persistent arseriaussyanproms ll swallowed:
Rinse out moulh and Then drink plenty orwalec ccmuh a doctor or
Poison carnal immediately, D D NOT IN DUCE VOMMHG. Comums
Wes. hemdmmoh and prapylere 91yod.
Mooufadumd by avdyadar. NC Broad, LB
40 Richard, Am Nvno@, Cr 06054
NO 751.I233 ww.aryo-pill.ram
O 2016 NC based, LP.
90123101601
Net Contents: 143 OR
.i
LIFE SAVER POOL FENCE
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st'�n�9 101p
OON
SYSTEM SP-90. WICATIONS
General Description:
Pool fence designed specifically to provide a barrier around residential swimming -pools
for toddlers and young children. Life Saver Pool Fence Systems ® does not have any
gaps, openings, indentations, protrusions, or structural components that could allow a
young child to crawl under, squeeze through, or climb over the barrier. Our exclusive
Perma Locking System will not allow the barrier to be removed without the aid of tools.
Life Saver Pool fence is manufactured and installed in compliance with the Florida
Residential 4501.17 and the Florida Statute.
System:
Tension based system utilizing a series of 15 foot sections of fence with inserts for
mounting in non -conducting polypropylene sleeves core drilled 4 inches deep into a
concrete deck or other substantial surface, connected in series at the top with our
exclusive 21/2 inch Perma Locking System
Construction:
Mesh: Polyester mesh fabric with a mildew resistant polyvinyl coating to provide for
years of use in direct sunlight.
Continuous basket weave with a tensile strength rating of 270 lbs. Per inch
making it impossible to rip under normal use.
Color selection is black white, green or brown. Available in 48 or 60 in.heights.
Bordered on all four sides by a reinforced vinyl material with a rating of 387
lbs. To prevent sagging and provide the necessary tension to insure the fence's
integrity for its intended purpose both at the top and bottom
The mesh is pre -mounted on aluminum support poles and secured by aluminum
cove molding strips.
Poles: Poles are constructed of marine grade aluminum, black, white, green, tan and
brown powder coated or silver finish.
Pole spacing is at 36 inches.
Stainless steel screws (14) are utilized for securely attaching the aluminum cove
molding to the poles and mesh.
Surface of the poles are finished for handling and to prevent injuries from
physical contact.
The poles are capped to provide a neat finished appearance.
Revised 11/10/15
Life Saver Pool Fence Systems, Inc.
Removable Pool Safety Mesh Barrier Fencing Technical Specifications
Life Saver Pool Fence Systems, Inc. has manufactured removable pool safety fencing
for over 13 years and has continuously evolved their methods and materials, often -time
leading industry wide changes. A Manufacturer's Limited Lifetime Warranty guarantees
every system for as long as they own it. Life Saver Pool Fence meets and exceeds all
code requirements throughout Florida Below you will find technical specifications on the
components used in assembling the Life Saver Pool Fence.
Textilene Mesh
Textilene mesh has been used as the highest quality material to the pool fence industry
for over 15 years. Laboratory testing shows its strengths to surpass all code specifications
and applicable ASTM standards.
Item Number. • T70 DFS
Product Description:
Fabric using .025" dia. vinyl -coated 1000 den. polyester core yams in the warp
and fill.
Construction, endfinch
D3775-96
13.0 + .5
Weight, ortyd'
D3776-96
— —
Tensile Strength (grab), Ibf
D5034-95
221.4
Tensile Strength (strip), Ibf
D5035-95
194.9
Tear Strength, (Trapezodial), Ibf
D1117-97
65.4
Ball Burst, IV
D3787-89
Bursting Strength, psi
D3786-89
Elongation, %
D5035-95
24.3
Abrasion Resistance
D3884-92
(CS10/50D cycles/ with no added weight)
Flammability Rating
Weatherability, 1200 hours
653-96
Mildew Resistance
G21-96'
The above results are a representative of real data from single test samples_
Presently no specification is incorporated.
11.0 + .5
213.3
153.8
54.0
335
433
21.6
No'exposure of core yam
CS-191-53 & CA 117E
No discoloration
No growth
Warp refers to the horizontal threading while fill refers to the vertical threading. As
shown, all testing confirms Textilene in meets and, on all strength tests, amply
exceeds the set code requirements.
Reinforced 1" Aluminum Pole
Life Saver Pool Fence uses Reinforced 6063T6 I" Aluminum Poles spaced no more than
36" apart. Mesh is secured to the pole via an aluminum cove -molding using roundhead
screws spaced no greater than 6".
The temper rating of T6 scores the highest tensile strength (30 ksi) within the 6063 alloy
classification.
On July 14'h, 2003, Life Saver Pool Fence Systems, Inc. contracted Nutting Engineers of
Florida, Inc., an ASTM standards testing lab established in 1967, to test the pole strength
as per the Florida Residential Code 4501.17
At the time of testing, a lateral force was applied to a single pole at a measurement of 36"
from the surface of the deck. In the test, the resistance to lateral pressure was found to
exceed 70 lbs. of pressure before failure on any single pole in a free standing installation,
thus exceeding the 52 lbs. of horizontal force prescribed by the Florida Building Code.