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HomeMy WebLinkAbout124698 Pic va-k-- * 1Zi(o`f rang Community ith GLENp Development Group NEW SWIMMING POOL PLAN SUBMITTAL AFFIDAVIT Ordinance #2046 Please type or print Date2..t4 202.O Property Address (c2J K . 121y - LA) ( J e Name of Property Owner L/ViCta..v j: 2y hro.4 I. I 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 will 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. loft I Si(oq / a5 Pet a -A -. katA(On IF YOU CHECKED BOX II B, PLEASE COMPLETE REVERSE SIDE WHICH IS THE NEXT PAGE IN THIS DOCUMENT THIS IS THE REVERSE SIDE OF THE PREVIOUS PAGE 1. ❑ The pool shall be protected by a motorized safety pool cover. 2. 0 Doors and windows are protected 3. 0 The pool shall be protected by an alarm maintained in or on the swimming pool. 4. 0 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 A_I-7)/i)AA 2_. fi4-_2D2_0 Name of Home Owner Home Owner Signature Date ,IN4_5-k Po© (s ^ - '-+_,.= '2 N /, Pool Contractor Contractor Signature Date SIGNATURE OF OWNER MUST B OTARIZED State of Arizona -% , . JAW 1.THOMPSOf •County of Maricopa gal MI On this /tday of fr2,6 , 20, , efore me, personally appeared Li►t Ct A VsJ&((S (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. . 2 of 2 I naq / 713s�