The URL can be used to link to this page

Home My WebLink About120501 8 JZ050 ( • GLENP NEW SWIMMING POOL BARRIER AFFIDAVIT Ordinance#2046 PPP bye or print Date gi/ C1 /19 Property Address I � 2 a N. 7 g r`A Ave e i t.,oh-)) A 2 gs 3©g Name of Property Owner Sec-Pr t y e_ I. ❑ No children less than six years of age reside at this address. II. W A child under the age of six years of age resides at this address. (If this box is checked, Identify method of secondary Dool nrotection-) A. ❑ We will provide an interior fence and enclosure around the pool as required by the Glendale Pool Barrier Ordinnep_ B. LY We will provide exterior fence and enclosure protection with secondary protection as checked on reverse side of this affidavit per the Glendale Pool Barrier Ordinance. (Complete Reverse Side) City of Giendele Development Services•5850 West Glendale Avenue•Glendale,Arizona 85301-2599•Phone(623)030-2800 www.giendeleazcam GLIND4tE ❑/ 1. The pool shall be protected by a motorized safety pool cover. t9' 2. Doors and windows protected. ❑ 3. The pool shall be protected by an alarm maintained in or on the swimming pool. O 4. The above ground swimming pool shall have a ladder secured. ❑ 5. Locking hard safety cover on the spa or hot tub. ❑ 6. Alternative protection not specified above which is attached to the plan submittal and submitted for approval by the building official. Afed 0.21 6./2, Name of Home Owner ) H. .. egirer Si, t. i Date Pool Contractor(Print) Contractor Signature Date SIGNATURE OF OWNER I UST BE NOTARIZED State of Arizona County of Maricopa On this?o day of -47.1 �-9/ . 20f') before me personally appeared �� (name of signer), whose identity was proved to me on the bas': of satisfactory evidence to be the person whose name is subscribed to in g s document, and who acknowledged that he/she signed the above/attached document. re''4/4.^ MICHAELC!YINES Notary Public-Arizona ` 4 ;? Maricopa County f 4 kjl My Comm.Expires Jun 6.2021 No blic City of Glendale Development Services,5850 West Glendale Avenue•Glendale,Arizona 85301-2599•Phone(623)930-2800 www.glendaleaz.corn