HomeMy WebLinkAboutAFFIDAVIT OF REQUIREMENT COMPLIANCE,, _ ,.- PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA 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
PERMIT #
I (We) acknowledge that a new swimming pool, spa, or hot tub will be constructed or installed at
5530 PLACE LAKE DRIVE
(Please print street address)
and hereby affirm that one of the following methods
will be used to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool.)
Z The pool will be isolated from access to the home by an enclosure that meets the pool barrier requirements of Florida Statute 515.29.
The pool will be equipped with an approved safety pool cover that complies with ASTM F1246-91(Standard Performance Specifications for
Safety Covers for Swimming Pools, Spas, and Hot Tubs).
XC+5 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. S j i� S H-- 6 Lit' l-.Ij Pelf? L /I 14- cE"c-Z
All doors providing direct access 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, 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 $500.00 and/or up to 60 days in jail as established in chapter 775, F.S.
I understand that the St. Lucie County Building Inspections Department assumes no liability for the final inspection of one of the
above protective devices, or the lack of maintenance, or the removal of such after the swimming pool has been finalized.
I, the contractor, agre o instruct the owner of the proper use and maintenance of such safety device.
CONTRACTORS[ E O R SIGNATURE
STATE OF O g$M COUNTY OF t %lei f fj F /( ST) TfkOF F RI A, COUNTY_-0F r Sff X XS T fic r ��
No vPuntic .^ ®,, 44LEEN G LOEHRI 'l
_� o.Notary Public -State of Flori;;:,
? Commission #
HH 136372 '
F� My Cornmi si rt Ex ires
The foregoing instr eiiff iii acknowlexleaadr�efe 0u
this # day of 20
Personally Known ,-% , or Produced Identification
Type of Identification Produced:
SLCPDS Revised 07/22/2014
The foregoing instrument
KATHLEEN G lOEHRIG
Notary public -State of Florida
Commission # HH 136372
My Commission Expires
e 01,, 2025
this i day of — b A/ 67 120 '
by _71JCV�
M14-
Personally Known or Produced Identification
Type of Identification produced: jj1 l (���