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GLENTD, E Development Group
NEW SWIMMING POOL
PLAN SUBMITTAL AFFIDAVIT
Ordinance#2046
Please tvpe or print •
Date �/ ,,Ru�
Property Address 1- y 36 c i• S a h g v r' Lek / .l• G IC 0 d al e
Name of Property 0/wner Dc yl J �ro�'Jd Y�F✓'
L No children less than six years of age reside at this address.
EL 0 A child under the age of six years of age resides at this artriress.
.. . • • . (If this bzrx is thecked;. dent f ra-Oh of- n y-pool-grortectirarx.).... . .
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.
(COMYLETE REVERSE SIDE)
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Community
0-13\lpfsE Development Group
1. 0 The pool shall be protected by a motorized safety pool cover.
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 lari i4 secured.
5. ❑ Locking hard safety cover on the spa or hot tub.
6. 0 Alternative protection not specified above which is Pt-Ache i to the
plan submittal and sub...•. d far ap al by the building official.
DaV id 2(ct nd.evilac
Name of Home Owner(Print) (!Ho> er Signature Date
Pool Contractor(Print) Contractor Signature Date
•
- - .. SIGNATURE OF OWNER MUST-BE-NOT
State of Arizona
County of Maricopa
r
On this 2 of \OJW)advq. , 20 \4 , before me personally
appeared 1 P,Y�[� ( `e frame of signer), whose
identity was proved to me on the basis o satisfactory evidence to be the person
whose name is subscribed to in this doetumkent, and who acknowledged that
helshe signed the above/attached document.
fee i w L, AMANDA HOOK
(` Notary Public-Stab catboat
+l. li AAARICOHn COUNTY
..> My Commission Expires
...,►yb ilk 2017_
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