HomeMy WebLinkAboutPALMISANO SAFT AFFIDAVIT_ a PLANiVING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGIMA AVE
FORT PIERCE, FL34982
(772)4621553 Fu(772)4674518
AFMAVIT OF REQUIREMENT COMPLIANCE
Residential Swimming Pools, Spa, and Hot Tub Safety Act
PERMT B
I (Vyc) acknowledge that anew swimming pool, spa, or hot tub will be constructed or installed at
-Sr - 0'*1774 Ala - -✓2rx' i and hereby affirm that one of the following methods - --
• (Phone print strut 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 a solosum that meets the pool border requirements of Florida Statute 515,29,
The pool will be equipped with an approved safety pool cover that complies with ASTM P1246A1(Standud Performance Specifications for
Solely Covers far Swimming Pools, Spn, and Hot Tubs),
All doors and windows providing direct no= from the home to the pool will be equipped with an ash Olson that has a minimum sound
pressure reflngof85deciheis at 10 feet
At: doors providing dirwtaccoss earn the home to thr, pool will be equipped with selfelosing, selflatcidng devices with ale se mechanisms
placed no lower (ban S4 inches above the floor or deck
I understand that net having one of the above lutalted at the time of final inspection, or when the pool is completed for contract
Purposes, will constitute a violation orchapter515, F.S., sad will be considered as committing a mtsdemmmor of Cite second degree,
punishable by fines up to $500.00 and/or up to 60 days in jail ns established in chapter 775, F.S.
I understand that the SL Lucie County Building inspections Department ammot s as liability for the final inspection orono of the
ahoyn protective devices, or the lack of maiatcm wuc or the removal ofsuch eft the swimsr4iag pool has been finallud.
i, _the
�contractor,
^agree to instruct the owner of the proper use and
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CONTRACTO ATURRR 0<
NT STATE OF FLORIDA, COUY OF ��� (/.CY/e?
(jTARY PUBLIC •
The foregoing instrument was acknowledged before me
'ysl /
lhis�day of .iteL 20
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by Zt �l
Personally Known orPruduced ldendficition
Type of Identification Produced:
SLCPDS Revtcd 07f13Q014
""""". JOANNEWILLS
Commission#GG2I2913
o Expires Februw120, 2023
Banded Thor Troy Fain Insurance 800,385,7019
device.
STATEOFI7.O�IDA,COtR4TY OF •fir Ld''-"�"'�
PUllLIC
The
this
foyreQgoing instrvmm�t cans
day or
aelnowiedged before me
�ki 20,
Persanally Knoor Produced Identification
wn
Type of Identification produced:
•;c}•"•"�k�;; JCANNEWILL3
t� Commission#GG272813
Zy Pi��` Expires Februz:�20, 2023
•' Bonded Th:u Troy Fain Insurance 800385.7019
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