HomeMy WebLinkAboutAffidavit Of Requirement CompliancePLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Cade Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(M) 4624M Fax (772) 462-IM
AFFIDAVIT OF REQUMMPNT COMPLUNCE
Residential Swimming Pools, Spa, and Rot Tub Safety Act
PERMIT #
I (We) acknowledge that a new swimming pool, spa, or hot tub will be constructed or installed at
120(e3 5 IN DTAL►J Q(yc-I a 1>c N•Si---tj 14 M4,s7 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 91(Standard Performance Specifications for
/ -- yy Safety Covers for Swimming Pools, Spas, and Hot Tabs).
N 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
pressurerating of85decibelsat 10 feet.
All doors providing direct access from the home to the pool will be equipped with self dosing, 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 andfor 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, agree to instruct the owner of the proper use and maintenance of such safety device.
t
CO CTOR SIGN TURE AA C49ER SIGNATURE
STATE OF FLORIDA, COUNTY OF M tcaltj STATE OF FLORIDA, oCOUNTY OF HA—y W
N ARY PUB C NOTAR UBLIC
The foregoing instrument was acknowledged before me
this day of , 20 1 1
by QyA0 FIGMAJ
Personally Known )c--_ or Produced Identification
Type of Identification Produced:
The foregoing instrument was acknowledged before me
this ZSs day of OF6 2015
by J&ktJ MAL.AnJCZVfl
Personally Known or Produced Identification
Type of Identification produced: hDL 11462•V(,6-53 &53`6
JULIE M SCALISE
MY COMMISSION # GG091020
EXPIRES April 06, 2021
SLCPDS Revised 0742/2014
:? `��: JULIE M SCALISE
:�- MY COMMISSION # GG091020
°�► EXPIRES April 06, 2021