HomeMy WebLinkAboutAFFIDAVIT OF REQUIREMENT COMPLIANCE�F
6 _ , PLANNING & DEIVELOPMENT SERVICES DEPARTMENT
• Building and Code Regulations Division
2300 VIRGINIA AVE
p�� a FORT PIERCE, FL 34982
St Lucia county � (772) 462-1553
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
AApC„loo u d SL&Ci C- and hereby affirm that one of the following methods
(Plelsl print street address) 1
willpbb used to meet the requirements of Chapter 515, Florida Statutes: (Please initial the method used for pool.)
V 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 pas, 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 85decibels at 101feet.
JAll 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.
Swimming pool alarm placed i pool meeting ASTM F2208
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, agree to instruct the owner of the proper use and maintenance of such safety device.
I l
CON CRA TT OR SIGNATURE I O ER SIGNATURE
STATE OF FLORIDA, COUNT
Y OF � - l STATE OF FLORIDA, COUNTY OF
i I
NOTARY PUBLIC
The foregoing instrument w`as acknowledged before me
r
1�
this _day of 201'(+
by K : m (w
Personally Known
Type of Identification
r, o+5
or Produced Identification
DANYELJONES
SLCPDS Revised 03/28 9i,;;,
MY COMMISSION itFF 198907
44, EXPIRES: June 12, 2019
` Sonded,Thru NotavyPubGcUndenxdteni
NOTARY PUBLIC
The foregoing instrument was acknowledged before me
this 10 day of t , 201i_
by 'S a. C e. (,( Q in 1 CP. �-
Personally Known_ or Produced Identification
Type of Identification produced:
r + + 'jm'1 Ji5fil'JN I FF 198907
;tine 12,20 ^ =
y Public Uz• +rs
Planning &I Development Services Department
Residential Pool Permit Checklist
When applying for a residential pool permit use the following checklist.
COUNTY
F L O R I D A
Building Permit
11
A completely filled out building permit application shall be
Appl8caft--r-4 ®
I
submitted, including all required information. The
BY
application shall be signed by the applicant(s) and the
St LUCIG®Ui1tt/
signatures shall be notarized. If the applicant is the
contractor/qualifier, the application requires 2 signatures.
Notice of Commencement
V 1
A recorded Notice of Commencement for all construction
with a value exceeding $2,500 shall be submitted prior to
first inspection.
Construction Plans
2 sets
All proposed construction must be accurately shown on the
plans including but not limited to electrical wiring,
plumbing, and pool equipment detail. Both sets of plans
shall be signed and sealed by a Florida registered engineer.
Plot Plans/Surveys
V 2
2 Scaled Plots Plans with all dimensions of pool and deck
area. include location of pool equipment. Show setbacks
of the pool/deck to all property lines and -location of all
existing structures. Form -board survey shall be required
for poured concrete decks. Final survey shall be
required for paver decks.
Vegetation Removal Permit
1
A completely filled out vegetation removal application must
be submitted with the building permit application. Please
include one (1) survey or site plan, for review by the
Environmental Resource Department. A specific plan
for tree removal and preservation is required if
applicable.
Subcontractor Agreement
1 each
One subcontractor agreement with original signature is .
required for each subcontractor on the job. The building
permit cannot be issued until it has been determined that all
subcontractors are properly licensed and registered. The
use of unlicensed contractors is strictly prohibited.
Filled Land Affidavit
V 1
This form is required for all construction, except for
interior renovation. It shall bear the original notarized
signature of the property owner. This affidavit serves to
notify the property owner of their responsibility not to
adversely impact their neighbor's properties with
stormwater drainage and runoff.
Pool Alarm Affidavit
1
Indicate the type of barrier/alarm. Shall be signed by
property owner and notarized.
****An Application for a Pool Permit shall not be accepted without a Pool Enclosure permit application
and plans or a fence permit (or proof of existing fence enclosing proposed pool area).
Revised 3/15/2011