HomeMy WebLinkAbout6. Compliance affDocuSign Envelope ID: CE8A3C40-1AA2-4B66-85A6-06715910741F
"mmos� PLANNING & DEVELOPMENT SERVICES DEPARTMENT
sue,, Building and Code Regulations Dirision
Atatn�nr 2300VIRGINIA AN
FORK PIFR('F, FI. 34982
072)462-1553 Fits 1772)462-1578
AFFIDAVIT OF REQUIREMENT COMPLIANCE
Residential Swimming Pools, Spa, and Mot Tub Safety :Act
PERs1FIq
i (We) acknowledge that a new swimming pool, spa, or hot tub will he constructed or installed at
1200 PARKLAND BLVD , and berebY 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 Ilk 'Ill It III be LUI.IIQI hwn acre. t„ the h.nuc ht nn rm ItI'M, th:u ❑ICCI. I;r p,nd h:urin rcyuncmcut. I'I I ;It [,I,! Slatutc
Th, lnnrl mdl he ryu q.pai t�ith nn eppratctl ..d.n Isrol 11a1 N III .1ST 41 II=Ab.01 Siand:ud Pa G II1IW r Spa ilicwun. Irn
'Iatetc r -ot lr} 6tr itc11n1nmg Puol,t. 11td._ Il Ilrn 1 uh.1
X
\0 drn I, and tvwd„lk, I"I dir3...nv. t'n•m the hr,mc in III, III hcegmppnl v, th an e.:❑ alolni Ihni lid, a nnnunwn _.nund
_.. prc,+urc ranne nt S4lcnbch III Iu I"I
All dnor. pion ikbng duets at.ca, h"nn the h.nno to the Ix,-'l o ill be cympped It Ielt clusin_e. ,It IACIIIIIP d.9lCC. Will rcicinc mnchdm>an.
placed [Ilk I-11e1 th:n+. 4-1 1111111, .Ibis, the 0-0[ ni dec6_
I understand that not hating one of the above installed at the time of final inspection. or is, licit the pool is completed for contract
purposes, will constitute a tiolation of Chapter 515. F.S., and still be considered as committing a misdemeanor of the second degree,
punishable by fines up to 5500.011 and/or up to 60 days in jail as established in chapter 775, F.S.
1 understand that the tit. Lucie County Building Inspections Department assumes no liabilityfor the final inspection of one of the
abuse protective desires, or the lack of maintenance. or the removal of such after the swimming pool has been fmafaed.
I, the///co///ntractor, agree to instruct the ossner of the proper use and maintenance of such safely desire.
DocuSianed by:
V ACTOR SIGNATURE
ST ATF. OF FLORIDA. COUNTY OF St Lucie
Kerry A. Sisson
SOT:(RY PUBLIC
The foregoing instrument was acknowledged before me
this 3 day f March 21121
Warren Sigman
b>
Personally Known X or Produced Identification
Type of Identification Produced:
SLCPDS Revised 07122,2014
S11 ATE OFFLORIDA. ( OIL NT\OF St Lucie
Kerry A. Sisson
NOTARY PURIA
1-he foregoing instrument "as acknowledged before me
this 3 this n,March 2021
Lori Blazer
Personally Known or Produced Identification X
Type of Identification produced: 1) L
�,y Pu. Norory Public State of Florida
Kerry A Sisson
aw p my commission GIG W0211
d Expires 01/2212024