BUILDING DEPARTMENT
104 North Riverside Drive
Edgewater, Florida 32132
Phone: (386) 424-2400 X 1514 FAX: (386) 424-2423
POOL/SPA SAFETY AFFIDAVIT
RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFETY REQUIREMENTS
Section R 4501.17, Florida Building Code- Residential
I (we) acknowledge that a new swimming pool, spa or hot tub will be constructed or installed at
, and my contractor has informed me that prior to the use of
my pool, I will need a safety barrier installed in accordance with the Florida Building Code-Residential (FBC-R) and
that all inspection approvals, including final inspection, will need to be obtained. FBC-Residential requires private
pools to be enclosed by a barrier meeting the requirements of FBC-R Section R4501.17. Residential swimming pools
with permit applications filed after October 1, 2005 must meet at least one of the pool safety barrier requirements
(please see options listed below).
Please initial all methods to be used for your pool.
The pool will be isolated from access to the home and yard by a screen enclosure that meets the pool barrier
requirements of Section R4501.17 FBC-R.
The pool will be equipped with an approved safety pool cover that complies with ASTM F 1346. (Standard
Performance Specifications for Safety Covers for Swimming Pools, Spas and Hot Tubs). FBC-R4501.17.
The pool will be equipped with an approved removable child mesh safety barrier not less than 20-inches to the
water’s edge and compliant with FBC-R4501.17.1.13 and R4501.17.1.15.
All Doors and windows providing direct access from the home to the pool will be equipped with an exit alarm
comply with UL 2017 that has a minimum sound pressure rating of 85 dB A at 10 feet (3048 mm). The exit alarm
shall produce a continuous audible warning when the door and its screen are opened. The alarm shall sound
immediately after
the door is opened and be capable of being heard throughout the house during normal
household duties. The alarm shall be equipped with a manual means to temporarily deactivate the alarm for a
single opening. Such deactivation shall last no more than 15 seconds. The deactivation switch shall be located
at least 54 inches (1372 mm) above the threshold of the door. Separate alarms are not required for each door
or window if sensors wired to a central alarm sound when contact is broken at any opening. FBC-R4501.17.1.9.
All doors providing direct access from the home to the pool (not equipped with exit alarms) will be equipped
with self-closing, self-latching devices with positive mechanical latching/locking installed a minimum of 54”
(1372mm) above the floor or deck, which is approved by the authority having jurisdiction. FBC-R4501.17.1.9(2).
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 515.27, F.S. and will be considered as
committing a misdemeanor of the second degree, punishable as provided in Chapter 775.082 F.S. or 775.083 F.S.
I also understand that steel & ground and deck inspections are required in addition t
Inspection access to the interior of the home is required if alarms on windows & doors or if self-closing/self-
latching doors are used to meet the above requirements.
REVISED 7/21/2015
