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Home My WebLink About81711 • YS 7 s' FP", Community lib G Development Group ADDENDUM TO BUILDING PERMIT NUMBER(S) 8 I -7 I 1 The undersigned applicant asserts that he/she is exempt from the contractor licensing requirements of Arizona Revised Statutes Chapter 10, Title 32 on the basis of: ARS 32-1121.A.5 The applicant owns the property and shall occupy the property,and does not intend the property to be for sale or rent, and shall have the work performed by the applicant alone, or by the applicant with employees of the applicant, and/or performed by duly licensed contractor(s), all of whom are identified below or on the attached. ARS 32-1121.A.6 The applicant owns the property and shall have the work performed only by duly licensed contractor(s), all of whom are identified below or on the attached. Contractor/Company Name License Number Classification ARS 32-1121.A.7 The applicant is a registered architect or engineer,or employee of a register architect or engineer engaged in professional practice, not as a contractor. The undersigned swears and affirms that the information herein is true and accurate, and acknowledges that the filing of an application containing false or incorrect information with the intent to avoid the licensing or tax requirements of the State of Arizona is"unsworn falsification", a criminal misdemeanor. C�✓l= rh Jn19.S S 4113 f r 7 5 i Phase Company Phone email Engineering&Plans City of Glendale Starling Madison Jason Cromer 602-438-2500 Layout DLM Dean 602-882-3457 dlmexcavation(d)_yahoo.com WS Trucking Elizabeth 623-939-4384 wstruckingalcox.net Michael Michael 602-619-7665 Excavation DLM Dean 602-882-3457 dlmexcavationCcD_yahoo.com DSE Kent 602-741-6042 dsekent(cDvahoo.com C&R Brandon 602-390-0757 Imperial Excavation 602-368-6475 Imperialexcavatingnicox.net RP Excavating 602-252-1635 filldirtArpexcavatinq.com Tom Nichols Excavation 602-992-6305 tom(cD.tomnicholsexcavatinq.com WS Trucking Elizabeth 623-939-4384 wstruckinq(cD.cox.net Plumbing Bill Duncan Bill 480-988-1711 billaduncan-plumbina.com Klyns Pool Plumbing Bob 623-931-5237 KIyn7240gmail.com Equipment Az Wholesale Pool Equipment 480-551-7077 orders(caazwpc.com Leslie Pool Steel Discount Steel Mary 602-243-6434 discountsteelpools(d).yahoo.com Scholz Rebar Placers-Calif Pools BJ 602-246-7665 bl.gilbertsonnscholzrebar.com Electrical Springs&Sons Electrical Sherri 602.242.3500 officeCD_sselectrical.biz Hagarty Electric John 602-264-7442 dcrain(cD_hagartvelectric.biz Brandon Brandon 602-618-6298 Shotcrete/Gunite Adams Shotecrete 602-431-6657 shotcretebyadamAhotmail.com Coast to Coast Steve 602-763-5800 koolpoolquvL cox.net American Shotcrete 480-833-8068 bfish519(cDaol.com DSE Kent 602-741-6042 dsekentCcD_yahoo.com Tile Nobel Tile 602 454-2955 Plaster/Pebble Tec Superior Pool Plaster Elizabeth 602 249-3018 schedule(CD_superiorpoolplasterinq.com Superior Pool Plaster Elizabeth 602 249-3018 scheduleCDsuperiorpoolplasterinq.com Swimming Pool Service&Repairs 602-267-7203 TellMeMoreAPoolFix.com Swimming Pool Service&Repairs 602-267-7203 TellMeMore(dD_PoolFix.com Prado&Sons 623-930-7430 newconst[cilpradoandsons.com Cool Deck Total Backyard Concepts $6ft+250 spa 602 791-5747 4/3/2014 AXP Internal Page 1 of 1 Still !P". Community GLENDfE Development Group NEW SWIMMING POOL PLAN SUBMITTAL AFFIDAVIT Ordinance #2046 Please type or print Date LI ) 3 1 1 Property Address cthS -7 M I s r Lv4► C,(c J'4( A-r_ eS 3)8 Name of Property Owner (32€.6 A ,,t-, J,-, 0 S o� I. El No children less than six years of age reside at this address. II. tX. 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. fa We will provide an interior fence and enclosure around the pool as required by the Glendale Pool Barrier Ordinance. B. El 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 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. ►A. Doors and windows are protected 3. 0 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. 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 G nE"v AMJS-) '1 t 31 /`f Name of Home Owner Ho e Owner Signat re Date Ocri,../,---4)6J, 1..0 c---,\ Li [ 31 IL( Pool Contractor Contractor Signature Date SIGNATURE OF OWNER MUST BE NOTARIZED State of Arizona County of Maricopa 47 On this •)�a day of '/ , 'M1 L% , 20 / / , before me, personally appeared G( r''Gy Pr MV4j Dco' ) (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. '�UWLEDGEMENT: STATE OF ARIZONA COUNTY OF MARICOPA 14 i,,.�{ NOTARY PUBLIC +" w STATE OF ARIZOtNA This ipjs ument was cknow!edged before me Maricopa County This -irk'?day of i''4'1i ,20 /`/ ttis' KURT HAMER !n witness whereof I herewith set my hand My Commission Expires May 01,2016 and offic' . r era! "OTARY Pu, '