HomeMy WebLinkAbout83071 s 5o7r
'aril Community
GLENDfE Development Group
NEW SWIMMING POOL PLAN SUBMITTAL AFFIDAVIT
Ordinance #2046
Please type or print
Date 6/5//
Property Address CJ �, �' • 1/e/CQi7/7 ? Ae
Name of Property Owner r- /4 a
I. \'1 No children less than six years of age reside at this address.
II. ❑ A child under the age of six years of age resides at this address.
(If this box is checked, identify method of secondary pool protection)
A. We provide an interior fence and enclosure around the pool as
required by 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
IF YOU CHECKED BOX II B, PLEASE COMPLETE REVERSE SIDE
WHICH IS THE NEXT PAGE IN THIS DOCUMENT
13
vcrwmmoPc*
IC*1 tt
4
- .4 : ; ir
ot •t: ,
. _
' •
_ . .
• is?! Th
• '
• ,s, .; *, ;1 • ; e
,...r.)!•! • ',() ' • •
t
• f '
• „I "' D‘• ,?., _1;
; • I- • .
ROPMf7.-47—* —;°41"-ti'&444:i *4*4.144;"'41/464 4 4441'
1 /- .;(1 „ , ,
Sc07/
THIS IS THE REVERSE SIDE OF THE PREVIOUS PAGE
1. la pool shall be protected by a motorized safety pool cover.
2. ❑ Doors and windows are protected
3. 1[11 pool shall be protected by an alarm maintained in or on the
swimming pool.
4. ❑ The above ground swimming pool shall have a secured ladder.
5. ❑ Locking hard safety cover on the spa or hot tub.
6. Anernative protection not specified above which is attached to the plan
submittal and submitted for appro al by the Building Official
-d zi v / i `67*
Name of Home Owner Home Owner Signature Date
Pool Contractor Contractor Signature Date
,SIGNATURE OF OWNER MUST BE NOTARIZED
State of Arizona
County of Maricopa
On this 5 day of JG'iu , 20 / V , before me, personally appeared
Act/ /%v4 (name of signer), whose identity was
proven 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.
` t o. JUAN A. ROSALES
_ .�, N�IPubt-aids dMtxona
V ` YAW
�J* Coat(Seal)
7 2010 No ary Public
14
V .
rir V
`1( 711: ,.•14
iy3.\;-toterf, vd
‘Li7C, -
• • • 1!. 1: 1,•
:• .ir
Otj) le5, j. •
• :1'
.4 , •virgare-Ai., 7"."-Vri .•;`,40.4,117. . -
• 'Tri,tutt rtvtrtraff ttit witntrofffp,-.11c4,71'ICI!! t_fr;!.
•
V.
.VV .
.(I
)t.:?:TIrit • ''• •
4" \ f4 '110-43° 1-14/ 74)
pol .Y.PAm'TirrNc .14 _
, • .
Vr.
VV _
._„_
;v.!'
1,..1;; l)f`f", r1i,ii .4)iifit t‘,1:
(1"),,,
•
83.1/48(.04.4%.4 MO, 'we*
_ .
clooktk)u.. .istiqx4.14 ; iA41
V114.0001VCCIPAU
frac:tom=
Ate(4,1"14,--)nw/if