HomeMy WebLinkAboutSafety aff.PLANNING A DE%'ELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, F1. 34902
(772)462-1553 Fail (772)462-157S
AFFIDAVIT OF REQUIREMENT COMPLIANCE
Residential Swiminiug Pools, Spa, and Hot Tub Safety Act
PERMIT 0
I (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at
7 Bob O'link Way, Port St lope FL 34906
f%ease Priml street addreui and hereby affirm that one of the folio, in g method
Il b ed to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool`)
Pool will he rv.lated from access o the home by an enclosure that this, the pool barrier requirements of Florida Statute 515.29.
The pool will be equipped with an approved safety pool coves that Complies with ASTM F1246AI(Standard performance SPeci6ationa for
Satcq' Cm
overs for Swimming Pools - Spas. and Hot Tubs).
11 doors and windows providing direr access from the home to the pool will be equipped unth an exit alarm
pressurc sung of S5dccfbeis at to feet
p�_.Saa„� H L uArb that has minimum sound
All Gars Providing direct from the home to the pool w•rll be equipped with self cloan�
Placed no lower than 14 inches above the floor or deck.
& "if latching devtus With release meslarmama
1 understand that not having one of the above installed at the time of final inspection, or when the
pool
Purposes, will constitute a "Ohnit ll of Chapter 515, F.S., and will be considered as committing a misdemeanor of the second degree,
punishaAle try Bra up to 5500110 and/or u Misdemeanor
is completed for contract
p to 60 days in jail as established in chapter 775. F.S.
1 understand that the St. l.ucfe Count, Building Inspections
above protective devices. Department assumes no habilfty for the final inspection of One of the
or the lack of maintenance, or the removal of syefr-f7ter / the swimming pool has been finalized
1, the corer fora to t f
R 0 astrttn the Owner M the prvrper uses• and
CO /^ CTOR SIGNATURE
ST OFFFFLORIIA.CO 'ry F v7'C Lf c4e
N ARYL
PUBLIC
The fo►"Wag tasnoaseat was acknowledged before me
this day of
20,20
Panonally Known` or produced ldentlfltaypn
Type Of Identification produced,
O.'VCIS
Josandra A. Ingraham
NOTARY PUBLIC
STATE OF FLORIDA
ComirrdlGG954178
SLCPDS Revised 07122/2011 Expires 3/9/2024
VM OF FLORIDA. C LTI L Lc CiCc
tl dt�
NOTARY P aWC�
The foregoing hash s ateat traa sclmowledged before me
this �15 day of —
,, I/ 20 Z U
by_LL1 �� 4 Kos
Personally Known or Produced identification
Type of Identification prod uc ��ihe�ndr8q Irlprah�n
.� STATE OF FLORIOA
'"• COtrarW GG954178
e Expires 3/9/2024