HomeMy WebLinkAboutCOMPLIANCE AFFIDAVIT - POOL - SPA - HOT TUBCOCIIVTY,,q k°
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PERMIT #
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division ----�
2300 VIRGINIA AVE I RECEIVED
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578 DEC 04 2018
AFFIDAVIT OF REQUIREMENT COMPLIANCE ST. Lucie
Residential Swimming Pools, Spa, and Hot Tub Safety Act
I (We) acknowledge that a new swimming pool, spa, or hot tub will be constructed or installed at
BY
St. Lucie County
15370 Skyking Drive PSL FL 34987 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 F1246-9 I (Standard Performance Specifications for
Safety Covers for Swimming Pools, Spas, and Hot Tubs).
XX 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 85decibcls at 10 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.
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 T
of such safety device.
CK
CONTRACTOR SIGNATURE V
/1 OWNER SIG RE
STATE OF F (& (rft' &4q^'' NOTARY BLIC
The foregoing instrument was acknowledged before me
this `� ( day of ✓ 20_1
by fC1lAAeC, 13` 6L,
Personally Known or Produced Identification
Type of Identification Produced:
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KARI NEVILLE
-Notary
PubliC-State of FloridaSLCPDS
Revised 07/2212 j•
Commissionq GG 087945"o•=
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NiyComm. Expires Jul 22, 2021 AondHthmugh Nntional NaWy Assn.
STATE OF FLORIDA, COUNTY OF Lr, I A 7C( e—
"'2. KINISERLY KOCH
NOTARY PUB IC E+ Notary Public - State of Florica
'A +•1 Commissior=GG 177e93
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The foregoing instrument was ackn v1eA-ed'6efdi9@da0@m.gh Na;c,a xeHg Asv
this p day of �LkN&Mio{i .20
by �{fASl�,2 `3 �115'�1�1� At)0eCgK.e-
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Personally Known or Produced Identification
Type of Identification