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Community
Development Group
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PLAN SUBMITTAL AFFIDAVIT
Ordinance#2046
Please type or print ''
Date 2 /2 O /(�_8.
Property Address 8 0 ,>0 N 6 !.S T" A V E
Name of Property Owner P 1 f K S ` E 6 E h
- I. ❑ No children less than six years of age reside at this address.
A child under the age of six years of age resides at this address.. .
: • .. . lam: .. ., . - _ �.� .. � - �.
.--:-(If this box is c.heciced;�Identi y method of-Secondly pool protection.) • -
--A-:—A—We will-provide an-interiO fence nd-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.
(COMPLETE REVEE SIDE) :R ,
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;Feb 19 08 04:44p Den Osborn 602-493-4927 p.2
VC 1_0/LVVO Iq:g4 rnn ezay iDZeao CUIi PLANNING DEPT fa002/002
Community
GIENEIE 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 alum maintained in or on the
swimming pool
4. . The above ground swimming pool shall have ladder secured.
5. ❑ Locking hard safety cover on the spa oz hot tub.
6. ;1 Alternative protection not specified above wif 6 attached to the
plan and submitted for approval building official.
NCy.
am of Home Owner(Print) Home Owner ignature Date
PrlPI 05jjofe /✓ 119604e/
Pool Contractor(Print) Contractor Signature Date
l SL b7NO j'aoL. S
_ .. ._.. _ .. .NIGNATURE QF OAR MUST-BE:NOT-ARTZ .—._ .. .
State of Arizona '
County of Maricopa
On this (94) day of .�'Q 20
��. �_. Cam, before me personally Q t—(C; a� �� (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.
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(seal)
Notary Public
ZSANENE OSTLUND
" P Notary Public -Arizona '
'UV Maricopa County
• „2 • My Comm.Expires Nov 6,2010