HomeMy WebLinkAboutREQUIREMENT COMPLIANCE - POOL - SPA - HOT TUB.,F
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772)462-1578
AFFIDAVIT OF REQUIREMENT COMPLIANCE FEB v 8 a
Residential Swimming Pools, Spa, and Hot Tub Safety At t
ST. Lucie
PERMIT #
vJl/
I (We) acknowledge that a new swimming pool, spa, or hot tub will be constructed or installed at St e� O
3022 NW Radcliffe WAY Palm City, FL 34990 and hereby affirm that one of the following methods UC/6 0
(Please print street address) ��/114 _
will be used to meet the re uirements of Cha ter 515 Florida Stat tes (Please initial th meth d used f 1) `Y
p/pl�s� q p , u i i e o or pan .
v The pool will be isolated from access m the home by an enclosure that meets the pool barrier requirements of Florida Statute 51529.
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).
1fiFi . 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 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 an 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 maintenance of such safety device.
CONTRACTORSIGNA'f IOWNE_ GNATURE
STATE OF FLORIDA, COUNTY OF ST-L-L .0 I * STATE OF FLORIDA, COUNTY 0FISH_ n e lP.
NOTARY PUBLIC v NOT Y PUBLIC
The foregoing instrument was acknowledged before me
this (cTH- dayof F(Z.OA-ay ,20 lOI ,
by 141N+A-eL A7U..C-r NeV-
Personally Known ✓ or Produced Identification
Type of Identification Produced:
MY COMMISSIGN #GG 1114371
EXPIRES:Odober 1, 2020
nded 7hm Notary Pubk Utderasilers
The foregoing instrument was acknowledged before me
this 0 day of 20_M—
by .4.k Q.rr
Personally Known or Produced Identification
Type of Identification produced:
SARA DONOVAN ALEXANDER
MY COMMISSION # GG 093050
EXPIRES: June 11, 2021
Bonded Thou Notary Public Underwriters
LISTINGREPORT
Intertek Testing Services N.A.
138SADAMS_COURT _ _ _ _ _ _ _ _ _ MENLOPARK,CAUFOBNIAQ4025
JobNo.:20018-32003MI lssoed:Pebmmy )4 200)
REPORT NO. 20382512
INSPECTION, TESTS AND EVALUATION:
OFA
GATE ALARM
RENDERED: TO
SmmtPo(d, INC.
t AKEW00D,N3:
Rcvised: Febmary20, 2001
General -Purpose Signaling. Devices and Systems, UL2017, 1'Edition,2000
and
Signal. Equipment Ccusumerand Commercial Prodmcs CSAC22.2 No.205-MI983.
Applicant Smanpool Inc;
,W5 Prospett.Stteet
Lakewood NJ08701
Mr.'Richard Holstein
Ph: (732)730.9880
Fw, (732) 73D-9881
CONCLUSION
doUcoveredby tWsreporthas:Heelevaluated andfoundtu tomlplywith theapplicable
afety ef0eneral-Pmposesigoal ng Devices ondSystevs; UL: 2017,1` Edition, 2000,
and Comuaercial Products (CSAC222No. 205-M1983):
dompletedby: ,Orin Mason' Signature:
AEr gi eel
}"TIDe ;.ssbdate'
' y„tlal8uy�.::)'PIYJi'j aJlrf��.
Prinf lmehina Mmmh 2001