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Environmental Protection and Growth Management Department
BUILDING CODE SERVICES DIVISION
1 North University Drive• Plantation, Florida • 954-765-4400 • broward.org/building
2007 5HVLGHQWLDO6ZLPPLQJ3RRO%DUULHU5HTXLUHPHQW
Permit #: _________________
Address: __________________________________________________________________________________
Lot: ________ Block: _________Subdivision:___________________________________________________
NOTICE OF REQUIREMENTS
I (we) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at the above address,
and hereby affirm that one of the following methods will be used to meet the requirements of Chapter 515, Florida
Statutes and Florida Building Code (FBC) Section R4101.17.
Please initial the method to be used for your pool
________ The Pool will be equipped with an approved safety pool cover that complies with ASTM F1346. Attach
manufacturer’s product compliance.
________ A continuous, one piece barrier (child fence, screen enclosure, or other fence) meeting the requirements
of FBC R4101.17.1 will protect the pool perimeter. Submit plans indicating the type and location of the
barrier, for child fence specify location of the end which is not removable without the use of tools. Attach
Manufacturer’s product compliance.
________ A combination of dwelling walls and or non-dwelling walls (screens, enclosures, fences, etc.) will
protect the pool perimeter. Submit plans specifying the type and location of all non-dwelling walls.
Attach Manufacturer’s Product Compliance information.
________ Any combination of protection which incorporates dwelling walls with doors and/or windows open-
ing directly into pool perimeter, which includes self-closing, self latching devices and/or exit alarms
complying with UL2017, FBC Section R4101.17.1.9 and installed in compliance with the current
edition of the National Electric Code (NFPA 70). Submit plans showing location and type of all
openings and specifying type of hardware or exit alarm to be used at each location for perimeter
protection. Proof of compliance, including NRTL listing of the alarm equipment and a sealed site
specific wiring diagram with circuit information, must be included with this application.
I understand that not having one of the above installed will constitute a violation of Chapter 515 FS and will be considered as
committing a misdemeanor of the second degree, punishable as provided in Section 775.082 or 775.083 FS.
*NOTE: Chapter 39 the Broward County Zoning Code requires that all swimming pools, and spas constructed in
any residential zoning district in the unincorporated neighborhoods be enclosed by a fence of 5' minimum height or
an open-mesh screen enclosure. All screen doors and fence gates must be equipped with self-closing, self latching
mechanisms.
Contractor’s Signature: ______________________ Print: _____________________________ Date: _________
Owners Signature: _________________________ Print: ____________________________ Date: _________
