HomeMy WebLinkAboutAFFIDAVIT OF REQUIREMENTPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 4624553 Fax (772) 462-1578
AFFIDAVIT OF REQUIREMENT COMPLIANCE
Residential Swimming Pools, Spa, and Hot Tub Safety Act scmfvr.L�
PERMIT # IX0 6• V" -siylBy
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I ) acknowledge that a new swimming pool, spa, or hot'tub will be constructed or installed at
.00 .6D ,Li 6 41_ lAie and hereby affirm that one of the following methods
(Please print street address).
wills be use -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 b an enclosure that meets the 1 barrier requirements of Florida Statute 515.29.
Y pool �N
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).
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 85deoibels at 10 feet
All doors providing direct access from the hometo the pool will be'equipped with self closing, self latching devices with release mechanisms
placed no lowerthan 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 oil such after the swimming pool has been finalized.
I, the contractor.,Wee to instr ct th owner of the proper use and maintenance of such safety device.
EONTRA0TOR SI NA-yW
i WNER SIGNATURE
STATE OF FLORIDA, COUNTY OF S l , U6 c
NOTARY PUBLIC
The foregoing instrument was acknowledged before me
thisl��_day of I v \ a` \I , 20 L 4
by
Personally Known or Produced Identification
Type of Identification Produced:
�"W� Notary Public State of Florida
SLCPDS Revised 0722/2014 A Thomasina Bowins
+= My Commission GG 201733
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EOFFLORIDA,COUNTY OF
NOTARY PUBLIC
The foregoing instrument was acknowledged before me /
this day of V / 774 20 / /�
,2/C-1,4w0 .S,
by L 1 A11) + .' ram
Personally Known 1__'or Produced Identification
Type of Identification produced:
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�., JO ANNE WILLS
a;Commission # FF 188304
�'�;� Expires February 20, 2019
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