HomeMy WebLinkAboutPOOL Affidavit compliance for permite PLANNING & DEVELOPMENT SERVICES DEPARTMENT
i
Building and Code Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553
AFFIDAVIT OF REQUIREMENT COMPLIANCE
Residential Swimming Pools, Spa, and Hot Tub Safety Act
PERMITH
I (We) acknowledge that /anew swimming pool, spa, or hot tub will be constructed or installed at
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.)
The pool will be isolated from access to the home by an enclosure that meets the pool barrier requirements of Florida Stable 515.29.
The pool will be equipped with an approved safety pool cover that complies with ASTM F1246-91(Staudard Performance Specifications for
Safety Covers for Swimming Pools, Spas, and Hot 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 of 85decibels at 10 feet.
All doors providing directaccess 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, trill 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 t,6, ingfr�ict t}ig+mvnen of
/( g'�roper use and maintenance of such safety device.
CONTRACTOR SIGNATTJRE
OWNER SIGNATURES
ST E OF FLOR V� �l�l. `
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'FATE OF FLORIDA, COUNTY OF 1 ' 1 n
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NOTARY PUBLIC
NOTARY PUBLIC
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The forle(�glgo'ing instrument was acknowledged before me
The foregoing instrument was acknowledged before me
this l day020 �
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this_ 'day of t Ali V- 204Z
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Personally Known or Produced Identification
Personally Known_ or Produced Identification
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Type of Id ii13) Mel:
SLCPDS Revised 04/112011
o` Lori A. DoSalvo
c NOTARY PUBLIC
ESTATE OF FLORIDA
e: COMW GG130649
to Expires 10/2012021
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o` hM1y Commission GG 098969
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