HomeMy WebLinkAboutFord barrier Affidavit (2)PLANNING & DI VELOPNIENT SERVICES DEPARTMENT
Building and Code Regulations Division
2.100 VIRGINIA AVE
FORT PIERCE, F1,34982
(772)46Z-1553 Fas4772)462-1578
AFFIDAVIT OF REQUIREMENT COMPLIANCE
Residential Swimming Pools, Spa, and clot Tub Safety Act
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I (We) acknowledge that a ne swimming pool, spa, or hot tub will be constructed or installed at
LWO D/. and hereby aflirm that one of the following methods
(Plrasr print.strert address)
will be used to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool.)
_/ The pooi will be iselat d from ncccsi to the home by an enclosure that meets the pool barrier regtnrrmentc of I -bin is Statute 515 29.
The pool wtll becquipped with an approved safety pool coi et that complies with ASTISI Fl246-FYI (Standard 11crforntan,:c Scecifttaiions for
Safety Covers fur Shimming Pane, Spas, and [lot Tubs).
All dosxs and windows pros [ding direct access from the home to the pool will he equipped with an exit alarm that has a mtnnnum sound
preswrc rating of 85deeibcIs at 11) feet.
All doors providing direct access from the home to the pool will be equipped with wifelosing. scif latching devices with releaw mccluinisms
placed no lower than 54 inch, abo%c the floor or deck.
understand that not having one of the above installed at the time of final lnspection. or when the pool is completed for contract
purposes, .vilI constitute a sioladon 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 mr liability for the final inspection of tine of the
above protective devices, or lite lack of maintenance, or the removal of such after the swimming pool has been finalized.
1, the contractor, agree to instruct owner of the proper use and maintenance of such safely device.
CONTRA[ OR SI(:NATIIRE ONVNFR tiIGNATURE
YTE OF FLORIDA- COUNTY OF LiA Uut STATE (IF FLORIDA. COUNTY OF
4-Lmpjlizm� WOA
1-IRY PUBLIC NOT.1Ry 1C
The foregoing instrument Ni as acknosslcdged before me The foregoing instrument ssns acknmvledged before me
Ihiday of �n r(t /� (� 20 this da
sgy of 20 2A
liv 1�1' I�1� _l o 1 I L by
Personally Known or Produced Identification Personally Known or produced Identlfication
Type of Identification Produced: Type of Identification produced:
TARAHENDERSI2ti tirr'.. TARAHENDERSON
r� . *F' Notary Public - State of Florida Notary Public State of Florida
�_ Commission N GG �24374 `
'?or ., My Comm. Expires Se 27, 2022 alt' +I ,z Commission a GG i14334
Bonded through Natloral Notary Assn" ? ar n°� My Comm. Expires Sep 27, 2022
St CPDS Bonded through National Notary Assn.