ERNISTINA PEREZ & FELIPE CARRETERO KENNEL PERMIT (K19-000063).PDF

Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT
K 19 - 0000(0 -3
APPLICATION
El New [(Renewal
Name: e,(1-c/Pit-t; 1'6 Kennel Name: Pe c- e k(env eAs
Mailing Address: 9,ay? s: edlic 3(-1'4201-0 Kennel Address: rn P
Cityadckiket p. State: AZ Zip: (96-pV A City: Zip:
County Supervisorial District:
Phone: )/36-6 Kennel Phone:
Please complete and sign this application and return it to the above address with payment in the amount of three
hundred fifty dollars ($350.00) within ten (10) days of receipt.
NOTE: Failure to renew the kennel permit by the expiration date of the previous year kennel permit will result in
penalty fees for each dog being assessed at $6 per month for unaltered dog and $3 per month for altered dog in
addition to the permit fee. It is suggested the renewal application be submitted 4 — 6 weeks in advance of the
expiration date to allow timely processing.
Pursuant to Arizona statute and county ordinance, a person must obtain a kennel permit issued by the Board
of Supervisors if the person operates a kennel in which there are five or more dogs which are not individually
licensed. A.R.S. §11-1009(A). A kennel is defined as "an enclosed, controlled area, inaccessible to other
animals, in which a person keeps, harbors or maintains five or more dogs under controlled conditions." A.R.S.
§ 11-1001(8).
An appointment will be scheduled for inspection of the kennel premises by an Animal Control Officer upon
receipt of this kennel permit artdication and fee. This kennel aiLiolication properly executed and a copy of the
inspection report will then be forwarded to, and must be approved by, the Maricopa County Board of
Supervisors. The kennel permit form will be sent to you after approval and will be valid for one year from the
date of the Board's approval.
NOTE: Failure to show for a scheduled inspection and/or failure of inspection will warrant a Subsequent
Inspection Return fee of $49 for each additional visit at time of inspection. Failure of inspection may result in
denial of the kennel permit and require individual licensing of each dog under the provisions of A.R.S. §11-
1008.
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
e assume complete responsibility for the kennel at the premises for which I/we are making
appliEga for a permit and understand that "kennel" means an enclosed, controlled area, inaccessible to

other animals, in which a person keeps, harbors or maintains five or more dogs under controlled
conditions (ARS 11-1001).
2. 14ie certify that I/We have dogs and that the kennel meets the definition in statute.
3. e certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
or 13-2 10. 1 (dog fighting), or similar violations of any other state, county or municipal animal welfare law.
(Violations of license and leash laws DO NOT apply).
4. (4.'. q-‘9‘ certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
premises of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to
practice in the state of Arizona and that a current vaccination certificate signed by a licensed veterinarian is
maintained on the premises for each dog.
5. e W.":4e certify that INVe are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
6. - understand that a dog remaining within the kennel is not required to be licensed individually under
A.R.S. § 11-1008. 1/we also understand that a dog leaving the controlled kennel conditions shall be licensed
under A.R.S. § 11-1008 except if the dog is only being transported to another kennel which has a permit issued
under this section.
7.6"ErIt4 understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
penalty of twenty-five dollars in addition to the annual fee.
8. (`', i'AF (,1( e understand that a person who knowingly fails to obtain a kennel permit within thirty days after
written notification from the county enforcement agent is guilty of a class 2 misdemeanor..
9. P, undersigned understand that that the kennel permit does not authorize the operation of any type
of business and is solely used for the purpose of licensing multiple dogs.
IANe certify that all of the information I/We have provided is true and accurate under penalty of law.
Applicant Signature (c".A,f4...r_44._. Date:
• Applicant Signature 4Y6.- 6Y 1013/6 Date: ilyplc//
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached
Copy of Person's Valid Identification Attached
Type of Identification submitted
BOS Approval Date Term of Permit
October 2015

Maricopa County Animal Care and Control
• 2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricoba.dov
Receipt Number: R18 -653790 Receipt Date: 12/19/2018
Person ID: P0829694
Phone: 480 2835048
• ERNESTINA PEREZ
9009 S CALLE SAHUARO 12/19/2018 10:36:35A1
GUAD,4LUPE, AZ 85283
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K19-000063 $350.00 1 $350.00
Total Fees Due: $350.00
Payments: Cash: $350.00
Check:
Credit Card:
Total Payments Received: $350.00
Thank You!
Would you like to share your experience with our service to you? Change: $0.00
Please visit our website at http://pets.nnaricopa.goy and click on Balance Due: $0.00
"Contact Us" to email -your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
andrewsa WBUSOFF

Maticopa County
Animal Care & Control
2500 South 27'h Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.marieopa.gov
KENNEL PERMIT K19-000063
PREMISE INSPECTION
Number of Dogs: 19
Name: Ernestina Perez Kennel Name: Perez Kennels
Mailing Address: 9009 s Calle Sahuaro Kennel Address: Same
City: Guadalupe : AZ Zip:86283 City: Guadalupe Zip: 85283
County Supervisorial District: 5
Phone: 480-283-5048 Kennel Phone: 480-283-5048
1. Are all dogs over the age of three months properly vaccinated for rabies and in
possession of a valid rabies vaccination certificate?
YES
2. Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a
person keeps, harbors or maintains five or more dogs under controlled conditions?
YES
NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit
Premise Inspection form.
CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND N/A DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
On December 19, 2018, Perez Kennels was inspected; there were 19 dogs on the property
and only 17 vaccine certificated presented. Since that day, Mrs. Perez has provided the
additional vaccine certificates, verifying all 19 dogs are currently vaccinated. The property is
enclosed and all dogs are secure.
Deputy Enforcement Agent & Badge #: Lt. Amber Romero Date: 1/31/19
October 2015

1213-
rtaW@CO OFFICIAL VACCINATION CERTIFICATE/Rx
affordable. quality. care. Vetcoainics.corn 1-877-838-7468 CA Date CZ,
First Name (Pe/Owner) Last Name (Pet Owner') New Custortier
Y N.
Address .APt/Silite
State Zip Spause/Partner's Name
Phone fit Returning Customer # ortRecart ( e- ail (iMPORTANT FOR COMMUNICARON)
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POR ARMONA RE.SIDEPff5 ONLY: lt yeu live irtMaricopa County ard are g Se "or (554-) License', please prolide you DOB for the County
Pet Name: i''''' , ' ,--• , :, Sew PA / 4F" Sy er: 01 Pet Name: •,---, -'" .,.. "- .^1.. Sew RI /^...t) Spey/Neuten .p.
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2 When... Year Peet lure verutruttons? . NIA , ... • 2 When was your pettiest vaccinations? IV/A
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6 Bona monthly lleuillek praventaMe: OYES 0 ' 5 ts co a monthly flou/nOtoreventorke: DYES &IVO
7 Is relerochippeal: 012$ ID HO 7 ts microchipped: 0 YEE 0 NO
8 Any known 4ner11,40 81 Arty drown allergte-7 in
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Veto. Name: Ra Tag il : ' ' :.-- • Vacc. Name: Rabvar3 Tag It ' C •
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Healthy Poiry / Healthy Dog / Heafthy Plus / Best Care Dog Healthy Puppy / Healthy Dog / Healthy Plus I• Best Care Dog
_ HealthyNitten / Healthy Cat 4wIr - 1Yr ./-•-•.Heeitity Kitten / Healthy Cat
0 _ NH? Purse Vecoine (Canine S-In-1DAZI4PPy li 0 DHP • Parvo .. Vaccine .. (Canine 5,in-1 DAZHPPLi) IIIIII
0 Bor4etelli . Vaccine In) .. Orai 0 Elordetella Vaccin'e •. .. . I 0'a 1111111111M11
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0 Lyme Vaccine . /I'I'r:i 'I' 0 Lyme Vaccine \ 1111
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0 Canine Influenza Vaccine 0 Canine Influenza Vaccine MM.
0 Rattlesnake Vaccine. •• ''... i.„..,.. 0 Rattlesnake Vaadine• 1.11111111111111111
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0 Tapeworm Dewormer dose 'LSD 0 Tapeworm Dewormer dose 1 5 0 . 1111111111111111111
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0- Feline Leukemia Vaccination 0 Mine Leukemia Vaccination ""• w
0 Feline Test FeLv P / N FillP / N KW P / N 0 Feline Test Feta P / N FIV P / IN HW P /.N
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1.- VACC.DIE TOTAL $ • 0 .. 1._ VACCINE TOTAL $ 0
Restricted/Prescri otion • for Oleo Soles 0111, Restricted/Prescripbon .• For Oleo Steles Only
0 TilfeYl 3 Heartgard 0 Sentinel 0 Revoluton (Fenn On/Ki 0 -frifexN 0 Heartgard 0 Sentinel 0 Revolution (Feline Orly)
CITY Strength Refill 0 0 /..------, Di? Strength Refill 0 (D I
Dosage ROA" Seed . / TOpitcd FON' Pelca-fy_ d ' Dosage ROA. Onti / Malta! ROT! ii,to_n.M.Ly_
0 NexGani ' 0 Comforts 0 Other - -:- 0 NexGard 0 Co fortis 0 Other
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Dosage ROA.: Oro/ FOU. . _ mi x 111 y_ ', . DOgage ROA * Orth pOu • Monthly ...- '
2. RESTRICTED/PRBSCRIPNON TOTAL .-.5 0 2- RESTRICIED/PRESCRIPTLON TOTAL 5 0 .

rtaw@co 1213 -
• OFFICIAL VACCINATIONSERTIFICATE/Rx _
affordable. quality. care. VetcoClinfcs.com 1-877-838:7468 CA 1,5tcrei Date
First Name (Pet Owner) Lest Name (Pet Owner New Customer
Address Apt/Suite
Qty Slate Zip pouse/Partner's Name •
Phone RetPra — • • e-mail IMPORTANT FOR COMMUNICATION
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FOR ARZZONA RESIDENTS ONLY: If you ive in Maricopa tounty and are getting a Senierk6S+) License;please provide your DOS forlhe traintyrr • '' • ' - "
Pet Name: ' '-....-• So..1_Pfli.1 ' $PaNtaleuter: c2.---- . Sell1M 11-.7Spay/Neuter: pr,...____
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1 Hos previously experLenoad a vaccination reactors: () ',..% goa , - 1 id. 9,avlausl. expellenced'a vaccination reactioni."(5 YES 0 ilLi. '.:
Z Whew/dap your pets lartyaccin4ona N/A. -- . a When was your pets 'eat vecolnotlem.,7 N/A .
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7 L.' .0 OthlOPOL I: C. YES 0.,NO 7 Is micro-chipped: '0 YES (DAC;
C. Art known allereN1 -7 - - ,,_- .3 ...IV /mown agergles7
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RAMS: SQ Killed 0 1YR 03 YR .. •MFG: BI . RAMES: SO Killed • 0 1YR -40 , ..3- . .yit , MFG: , SI
Vacc. Name: Rabvac3 Tag II: : ,== ! ', :-.1 Veer.. Name: Rabva a Tag,ii:
Serial It. - -- - — - - Mfg. Eip",-Cr3tEc."- . :',- ..1-r. - ':'--.. ' Serialli, -....-_.. -- M g. Exp."Itat.e:•'- • •," :
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Healthy kitten / Healthy tat .---, Healthy Kitten / Healthy Cat 4wit lye S
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0 Bordetella Vaccine _ ... lnj -,Oral- .„ • - - 0:. ..Bordetella V,accine .. ___ ..lo.• . Oral
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0 - •LeptosPirosis Vaccine - 0 . Leptospirosis Vaccine •-•
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0 4 ox Test. Nw ' / N L'an'' P i N 11111 0 -. : . 4 05 Test. NW P i N Lyme P / N • •
Ana P I N erl P / N • Ana F / N grI P f N
0 Lyme Vaccine --..... .. - 0 Lyme Vacdne
0 Canine influenza Vaccine • — • (3 Canine Influenza Vaccine
0 Rattlesnake Vaccine. 0 Rattlesnake Vaccine.
0 PYra ntei Pamoate 3.co/20P) or (1.cc/10#)___ocirnIs/P0 -- Q Pyrantel Pam pate iler./Z011) or (1.cc/1.01q _cc/rals/P0
0 Tapeworm Dewormer dose 1542 0 Tapeworm' Dewormer dose /.50 •. . .:
0 Fecal Test Pas Nag (3 Fecal Test Pot Neg.
0 Feline 3-in-1 (FVRCP) Vaccine , - 11M1111111 0 Feline 3-in ,-1. CFVRCP) Vaccine ., ' .• ,
0 Feline Leukemia Vaocinaiion. 11111111.1111 Feline Leukemia Vaccination . ..,, _.
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0 Feline Test Felv P/N . NV P / N Minf_.."17.N • 0 Feline Test FeLv P/N FIV P/N NW P/N .,.
0 • Oth,-, .•0 OTher . .
0 Microchip # Plat, fovr,- ,iere: 0 Microchip it PV..ce Sticker r-p.erc •
1._. VACCINE TOTAL ./ $ 0 a VACCINErOTAI. $ 0 .-
. Reotnicted/Preomnipttnn • kr Ulro.lc Sala s Ont., • Restricted/Prescription •••ForCIInfiSorecOnpo
0 Trifexis 0 Heartgard 0 Seniinel 0 Revolution (Mina anly) • 0 Trifexis 0 ileartgard 0 SentInel 0 Pevoludon (Feline Oniyi
c) i_____
Ur Strength • Refill 0 0 / QTY Strength eel C)
Dosage RCA', Oral ../ Topical -FOP' Adonehly', • Dosage RCA Onai / Mato' FOLI. Ntaltitly_
0 NeiGard 0 ComfordS 0 Other , 0 NexGard 0 COMfOotta, 0 , Other
QTY • Strength ' Refill 0 0 / ' , an' • 'Strength Refill © (D /____
Dosage ROA. • Oro/ CM" monthly • Dosage ROA' Oral ' FOU. Moriti
Z. RESTRICFED/PRESCRIPTION TOTAL :, . $ f) : ,:z. RESTRICYED/FRESCRIPT1ON TOTAL ,.. S et, - .. /

VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $.: Name
ADAPTED NASPHV FORM 51 Tag #: RABIES
PRINT - use ballpoint pen or type Cert. Serial #:
'wner's Name &Address U LYME DISEASE
PRINT LAST FIRST MI TELEPHONE CANINE DISTEMPER
,
o ANINE PARAINFLUENZA
NO. STREET CITY STATE ZIP O ANINE ADENOVIRUS 2
/ il/r- 5j- 7 u 7416 C77.'fiBc1., • ANINE PARVOVIRUS
SPECIES: SEX: AGE: SIZE: PREDOMINANT BREED: COLORS: • ANINE CORONAVIRUS
Dog 2M-T-0-3J Months - 0 Under 20 lbs. U---- i ,:( , is CANINE BORDETELLA
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Cat U Female 0 20-50 lbs. 0 ,r2-7 );.>< LEPTOSPIROSIS
Other U Altered 614- Years 0 Over 50 lbs. U NAME:
10 FELINE LEUKEMIA VIRUS
(Specify) 13 FELINE PANLEUKOPENIA
U FELINE RHINOTRACHEITIS
DATE VACCINATED: PRODUCER: Veterinarian's If
0 FELINE CALICIVIRUS
License No.
(First 3 Letters) U FELINE CHLAMYDOPHILA
Month Day Year
PRODUChNAW: Veterinarian's . - t• ease pri t
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VACCINATION EXPIRES: 1 yr. LicNacc. 0.1.
30 Signature V
3 yr. LicNacc. U
4 V50-196(i- Addre- IF
Month Day Year
Vacc. Serial (Lot) No. .
USCAHNON02066
VACCINATION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #: U RABIES
PRINT - use ballpoint pen or type Cert. Serial #:
Owner's Name & Address U LYME DISEASE
PRINT LAST FIRST MI TELEPHONE U CANINE DISTEMPER
fae re---2-- U CANINE PARA1NFLUENZA
NO. STREET CITY STATE ZIP 0 CANINE ADENOV1RUS 2
goe.5 9 _s-- , ..!.-. /7..,. 5.:;),/,L., 0 CANINE PARVOVIRUS
SPECIES: SEX: AGE: SIZE; PREDOMINANT BREED: COLORS: U CANINE CORONAVERUS
Dog- Pm-- Male 'd"- Months u Under 20 lbs. U :, , CANINE BORDETELLA
Cat a Female 0 20-50 lbs. d----- _i----)4A- 2/ e / LEPTOSPIROSIS
Other U Altered Years Over 50 lbs. 1:1 NAME:
U FELINE LEUKEMIA VIRUS
( 2:5/(bie U FELINE PANLEUKOPENIA
'5(03 5 0 FELINE RHINOTRACHEITIS
D,FE VACCINATED: PRODUCER: Veterinarian's #
'V da Li FELINE CALICI VIRUS
Lice -
( First 3 Letters) U FELINE CHLAMYDOPHILA
Month Day Year
PRODUrta NME: Veterina ' n's N. . (ple se print
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VACCINATION EXPIRES: 1 yr. LicNacc. cd
Signature
3 yr. LicNacc.
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Month Day Year ilk
Vacc. Serial (Lot) No. V .0
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CERTIFICATE c) Veterinarian's Veterinarian's Signature CERTIFICATE d PREDOMINANT PeCAC, Veterinarian's Veterinarian's
51 c NAME: Address 51 NAME: Signature Address
type type obi
FORM or G-0 0 0 FORM or COq
pen el' 0 0
lbs. , pen lbs.
point cub 20 lbs lbs. --*I point qr0 20 lbs lbs.
NASPHV ball -50 50 --5 No. NASPHV 50 50 No.
VACCINATION use 8TYJ SIZE: Under 20 Over (Lot) VACCINATION ball SIZE: Under - Over C.C.----(4-334-
- Letters) 01.4 use CrP6 20 (Lot)
q 0 B..,. MSS Serial - qh 0 K Letters) Serial
ADAPTED PRINT 3 C,_ ADAPTED PRINT NM 3
S Mo. older (First \lam S Mo. (First Vacc.
12 0 k,._,k. 12 older CA
RABIES to or RABIES or 0
011ie Mo. Lic.Nacc.X )1e to
FIRST AGE: Mo. Lic.Nacc. Mo. Mo. LiciVacc. Lic.Nacc
3 12 PRODUCER: FIRST C°I AGE: 3 12 PRODUCER:
0 4- Et yr. yr. 0 yr. yr.
3 1 3 1 3
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&Address STREET SEX: Male Female Altered ( EXPIRES: ...--/K. &Address EET Female Altered —{-1 Year Year
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. Name LAST? 013 VACCINATED: Day Day Name C) VACCINATED: Day Day
4, 0 0 VACCINATION LAST ° 1''' 0 0 —19
' Owner's PRINT NOQII SPECIES: Dog Cat Other (Specify) DATE Month Month VAC0410001 Owner's PRINT 9 SPECIES: 4: Other (Specify) Month VACCINATION VAC0410001
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Adciress Signature belki NAME: 51 CERTIFICATE Address Signature -1. NAME: Ull* Gogs 51 CERTIFICATE
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DATE VACCINATED: PRODUCER: Veterinarian's 41
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Month Day Year (First 3 Letters)
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1 yr. Lic.Nacc. 0 Signature
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3 yr. Lic./Vacc. Address
Month Day Year W S CM3311 A--CCi 7-7 5
Vacc. Serial (Lot) No.
VAC0410001