HomeMy WebLinkAbout12184 MaY . 26. 2004 i :54PM CARIBBEAN POOLS Na 0691 N . 1/3
1%-ard-cdE4 10•10 uiir ur ULENDALE 6234356966 P.02/03
4, 0-101-1
Community
Development Group�
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NEW SWIMMING POOL
PLAN SUBMITTAL AFFIDAVIT
Ordinance#2046
Please type or print '
Date 3 - 7 G.C,
Property Address S Z L \P-) C a W tl R Z C l ei O r
Name of Property Owner j tA(c I A tit] re I1CQ•
I. ❑ No children less than six years of age reside at this address.
IL A child under the age of six years of age resides at this address.
(If tlais•boa ked,idenaf'y wchdd-uf-secondary pool'pruteel;un.) • •
A. We will provide an interior fence and enclosure around the pool as required by
it the Glendale Pool Barrier Ordinance.
B. ❑ 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)
Received Time Apr .2U. 3:51PM
PAGE.02
MAY 26 2004 14:59
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May . 26 . 2004 : 54P'M CARIBBEAN POOLS N3 . 0697 P . 3/3
• APR-20-2004 16:10 CITY OF GLENDALE 6234356956 P.03/03
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Community
I eveloprent Group
1. 0 The pool shall be protected by a motorized safety pool cover.
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2. 0 Doors and windows protected.
3. ❑ The pool shall be protected by an alarm maintained in or on the
swimming pool.
4. 0 The above ground swimming pool shall have ladder secured.
5. ❑ Locking hard safety cover on the spa or hot tub.
6. E2 Alternative protection not specified above which is attached to the
plan submittal and submitted for approval by the building official.
6t r"C LO(kr 0
Name of Home Owner(Print) l :-c Owner Signature Date
Ca(< Let n poo (s
Pool Contractor(Print) Contractor Signature Date
- . , SIGNATURE OF. OWNER-MUST BE-NOTARIZED.-
State of Arizona
County of Maricopa
On this dayof I� , 20,0'1 , before me personally
appeared ', iV11 L J 4 (name of signer), whose
PP � )�
identity was proved to me on the basis of satisfactory evidence to be the person
whose name is subscribed to in this document, and who acknowledged that
he/she signed the above/attached document.
{�y R.TREVINO
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ALIILL4,01\ja-VO-
get; No ryPGblic-Arizona
COni
Marr •'i<� �_opo Coy�n• Notary]Public
lm .20. 3:51PM
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MAY 26 2004 14:59 PAGE.03