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Development Group
NEW SWIMMING POOL
PLAN SUBMITTAL AFFIDAVIT
Ordinance#2046 •
Please type or print /� c� .
v Date 7
Property Address 6 5 3 0) 19 6
r
Name of Property Owner (,Q
I. r4 o children less than six years of age reside at this house.
II. El A child under the age of six years of age resides at this house.
(If this box is checked, identify method of secondary pool
protection.)
A. We will provide an interior fence and enclosure around
poolqby
as required the Glendale Pool Barrier
Ordinance.
B. LI We will provide exterior fence and enclosure protection
with secondary protection as checked on page two of
this affidavit per the Glendale Pool Barrier Ordinance.
Pane 1 of 2
� .� • .Community ._
T Deve1oment Group
1 . U The pool shall be protected by a motorized safety pool cover.
ACKNOWLEDGEMENT:
STATE OF ARIZONA
2 El Doors and windows protected.
COUNTY OF MARICOPA
This instrument was acknowledged before me
This PS day of• S ,20 3. 3. Et The pool shall be protected by an alarm maintained in or on the
In witness wh f I herewithmy set hand
official.. `.\\ . ;, swimming pool..
PUBLIC
4. I The Above ground swimming pool shall have ladder secured.
•
SARAH DISMORE
1(1-
NotaryMaricopPublic•StateaCountyofArizona
My Commission Expires D
Ja nuar 30 2015 $. El Locking hard safety cover on the spa or hot tub.
6• Alternative protection not specified above which is attached to
• --� the plan submittal and submitted for approval by the building
official. • •
•
Parer 6
ON r e (printed) Own S•gnature Date
47/
Pool Contractor(printed) Pool Contractor Signature Date