HomeMy WebLinkAboutLocke Pool Alarm Affy - - IPLANNING & DEVELOPMENT SERVICES DEPARTMENT
KitidiliQ 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 s►vzmming pool, spa, or hot tub will be constructed or installed at
44 57 S` S L. A5� 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 Statute 515.29.
The pool will be equipped with an approved safety pool cover that complies with ASTM F1246-9I (Standard 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 g5decibels at l0 feet.
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.
f 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 contrac4sGN
to instruct the owner of the proper use and maintenance of such safety device.
i3V f'IlAC"1- I RF OWNER SIGNATURE
STATE OF FLORIDA, COUNTY OF ST L U C I E
NOTARY PUBLIC
STATE OF FLORIDA, COUNTY OF ST L U C I E
KEt�>Q�l a� • 51 Ssa
NOTA 1' PUBLIC
The foregoing instrument was acknowledged before me The foregoing instrument was acknowledged before me
this _ day of AoLi L) St , 2021 this � !�'- day of �Aa4 , 2021
by WARREN SIGMAN by g � Ld(!-r(-€
Personally Known Zor Produced Identification Personally Known or Produced Identification
Type of Identification Produced: Type of Identification produced: D L—
a � Notary PuOr State of Florida
Kerry A isson=tKer'�ry�
State of Florida
SLCPDS Revised 07/22/2014 yy_ My Comm ,lion GG 950211 onExpires �' '!2;2024 on GG950211
r2024