HomeMy WebLinkAbout118200 11 �2oo .
'LP". Community
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GLENDf Development Group
NEW SWIMMING POOL
PLAN SUBMITTAL AFFIDAVIT
Ordinance#2046
Please type or print
Date 5 ` ZO -- / D I
Property Address , 6 3 1 ) K Q 1 STA L U A `1
Name of Property Owner 1 R--A v i S £ A R `f
I. * No children less than six years of age reside at this address.
n. ❑ A child under the age of six years of age resides at this address.
^� •-1" . (If this box is.checked,identify method of• ewr marry pool-protection.)
A. D We will provide an interior fence and enclosure around the pool as required by
the Glendale Pool Bather 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.
(COMPLETE REVERSE SIDE)
111
Community
aINIE Development Group
1. ❑ The pool shall be protected by a motorized safety pool cover.
2. X Doors and windows protected
3. 0 The pool shall be protected by an alarm maintained in or on the
swimming pool.
4. . ❑ The above ground PwiTnInin3 pool shall have ladder secured.
5. 0 Locking hard safety cover on the spa or hot tub.
6. 0 Alternative protection not specified above which is AffArhed to the
plan submittal and submittP.d for approval by the building offirial
Name of Home Owner(Print) Ho e Owner Sipatnre Date
eG�U V(Iriler b J ooi 9
Pell Contactor(Print) on tor Signature Date
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--- SIGNATURE OF OWNER MUST BE NOTAIU -
State of Arizona
County of Maricopa
On this ok om' day of Mal , 20 19 , before me personally
appeared --r R' s r-, fl A R __J (name of signer), whose
identity was proved 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.
(seal) }120,1,;.,
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r BARBARA L G V�CIA
,.:'r NaryPitik•saeapnea►. Notary Public
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s„-f Ap910,2022