HomeMy WebLinkAboutPool Alarm Complaince AffDocuSign Envelope ID: D94C1 B68-2687-4Ai D-9C07-C7AC828DB35E
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VI RGI N I A AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
AFFIDAVIT OF REQUIREMENT COMPLIANCE
Residential Swimming Pools, Spa, and Hot Tub Safety Act
PERM IT a
1 (We) acknowledge that a new swimming pool, spa, or hot tub will be constructed or installed at
5oi(a 1 FT PSckG: 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 poo' will be isolated from access to the home by an enclosure that meets tie pool barrier requitement of Flntida Statute 5; 5'29_
The pouf twli be equipped "on an approved safety pool covet that complies with ASTM F1246-91(Standard Performance Specifications for
�/ Safety C ocors tot Swimming Pools, Spas, and Hot Tubs)
_^ All door, and windows providing direct access from the home to the pool will be equipped with an exit alarm that has it minimum sound
pressure rating of 85deci bets at 10 feet.
All doors providing three: access from the home rn the pool will be ccwopcc with scat closing scif ia:chine dcciccs 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.
1 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.
1, the c actor, agree to instruct the owner of the proper use and maintenance of such safety device.
n,ned by:
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CONTRACTOR SIGNATURE
RSIGN
OWNER SIGNATURE
STATE OF FLORIDA, COUNTY OF Martin
Kerry A. Sisson
NOTARY PUBLIC
The foregoing instrument was acknowledged before me
this a). day of Ml)'9-,(t-If , 20 a
by Warren Sigman
Personally Known Ixor Produced Identification
Type of Identification Produced:
STATE OF FLORIDA, COUNTY OF Martin
Kerry A. Sisson
NOTARY PC BLIC
The foregoing instrument was acknowledged before me
this ;t day of 61l A(LC.i-{ , 20 Q
by. Kenneth & Lynn Brown
Personally Known or Produced Identification
Type of Identification produced: D (—
a
llotary Pubtic State d Flondc yar Notary PubNc State d Fbrioa
Kerry A Sisson f IN Kerry A Sisson
My Commisawn GG 950211 My Commisss GG 950211
SLCPDS Revised 07/22/2014 Expires 0ll22/2024 assP Expires 0l/22I2024