Loading...
HomeMy WebLinkAbout81253 P E3 / 53 .1 0( ,-.) 3 , ,,,,--, 7,,.,: c.,,,,,,.„0,,,,,Iy, • ,.1 3! C. J 7 GL i L E'V 0 �© pmG�cllt . non io) NEW SWIMMING ING OOL PLAN SU MITi 1L AFFIDAVIT Oli durance#2046 Please type or print Date_-- GA ie/ i L Properly Address. Prig (A•/ 4 og.reAr Ave, ellen ed6 Ll Name of Property Owner Jiro #el/2.0 i fkJU/k4i/L I. ' No children less than six years of age reside at this address. H. ❑ 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. 0 We will provide an interior fence and enclosure around the pool as required by the Glendale Pool Barrier Ordinance. B. 0 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. • • 13 • 3 .1 .. T 7. :'1 1 ?Th 7 ._. .l' 4 n1 ^I Pr 'lr.','_'1 r..'1•; 11I l'_7 21i 1 WHICH IS TEE•+ NEXT PAGE Ms.1 TEO 3.(GCflJMENT THIS IS Ti IlM+ REVERSE SIDE OLD'THE PREVIOUS PAGE • 1. 0 The pool shall be protected by a motorized safety pool cover. 2. 0 Doors and windows are protected 3. ❑ The 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. 0 Locking hard safety cover on the spa or hot tub. 6. 0 Alternative protection not specified above which is attached to the plan submittal and submitted for approval by the Building Official Name of Home ner Home Owner gnature Date PH'nl�AL.S/1',6i wiiiTE ftys (JAL- o2Y/ 2(D//4,‘ Pool Contractor Contractor Signature Date SIGNATURE O) 'OWNER_MUST HE NOTARIZED IZED State of Arizona County of Maricopa On this r,t day of 41u,Q,aly, 20 /1 , before me,personally appeared L/, a hE I aa!•/A, _ (name of signer), whose identity was proven to me on the basi f 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. 14 ' BARBARA JEAN DURBIN �+ P►�EIe•81Med� Myl oii.1i,Non Exphra DeaDec•*2017