HomeMy WebLinkAboutPV2021-227 - Permits (2)City of Newport Beach - Building Divistion
. PO Box 1768 Newport Beach, California 92658-8915
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SOLAR Permit: PV2021-227 *PV2021-227*
Permit Counter Telephone (949)644-3288
Inspection Requests/Telephone (949)644-3255 Project No : 2699-2021
Job Address: 48 CROOKED STICK NB(
Issued Date : 12/09/2021
Description:SFR SOLAR PHOTOVOLTLT AIC/ .BOkw(DC),
(12) OOF MOUNTED
PANELS
Inspector Area: 4
Legal Desc.: N TR 15391 LOT 56
Owner: DABDOUB MARISOL
Contractor:
TESLA ENERGY OPERATIONS Architect:
Address: 48 CROOKED STICK DR
Address:
2102 ALTON PARKWAY #B Address:
+"`• `.
NEWPORT BEACH, CA 92660
IRVINE CA 92606
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Phone:
Phone:
650-638-1028 Phone:
State Lic: °
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Applicant: ALLEN BRIDGET
Con State Lic:
888104 Engineer:
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Address: 2102 ALTON PKWY #B
Lic Expire:
1213112022 Address:
• • °
IRVINE CA 92606
Bus Lic:
BT30026827
Phone: 714-450-2839
Lic Exp Date:
02/28/2023 Phone:
State Lic:
Code Edit: 2019
Worker's Compensation Insurance Designer:
WYDAJEWSKI CHRISTIAN
Type of Construction: VB
Carrier:
ZURICH AMERICAN INS Address:
2102 ALTON PKWY #B
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Occupancy Group: R3/U
Policy No:
EWS107458604
IRVINE CA 92606 +. "
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No of Stories: 2
Expire:
1013112022 Phone:
714-450-2839 ®O°•
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Building Setbacks
Rear:
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Use Zone:
Front:
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Bldg Height: 0
Left:
Right:
Valutaion: $25,500.00
Building Permit Fee $240.00 Record Management (8 1/2 X 11) $0.00
Plan Check Fee: $210.00 Record Management (Plans) $0.00
TOTAL FEE: $450.00 Plan Check Fee : $450.00 Fee Due at Permit Issuance : $0.00
PROCESSED BY: 65
A
ZONING APPROVAL: ( r' J V — /
GRADING APPROVAL:
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE AND CARBON MONOXIDE DETECTORS ARE EXISTING PER CRCR 314.1 & 315.2
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OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
(Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires thSppplicant for
the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and
Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or `) portions of the work, and the structure is not intended or offered for sale (Section 7044,
Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or
im roved for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
❑ 1 am exema Trb"I9 pensure under the Contractors' State License Law for the following reason:
By my signature beleN I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal)
sedl.a.structure that I Nave built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
Professions Co5q,iS aBailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
§ig;Waturg of Propejty Owner or Authorized Agent Date
PICENSED CCNTRACTOR'S DECLARATION
I*Nerelsy"affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force
anc%fiect.
,.ii;PVV Class " "' License No Date ><* ���� �ZZ Contractor Signature �)C
W,QRKtRS' CdMPENSATION DECLARATION
WORN 'N(4FAILU RE TQ SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
BOSF OF COMPENSARION{DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
;4Vn a and Oil Wfttain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
performance of t11E"worit for which this permit is issued. Policy No.
have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatio
insurance carrier and policy number are: /
Carrier k 1 _ Policy Number Expiration Date
Name of Agent r7-e-e- Phone #
I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
that, if I should become subje�r,{j.t�o the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 31
Signature of Applicant � t' /�/'f� Date U
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
Lender's Name Lender's Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to ente he abo -identified property for inspection purposes.
Signature of Property Owner or Authorized Agent -�� Print Property Owner's or Authorized Agent's Name
ACTION DATE BY DECLARATION OF COMPLIANCE INlTR CODE OF FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF T17LE40 AND
AQMD RULE 9403.
PERMtT EXPlR€D
❑ ISUDMITTEDAS8EST05 NORF1CATiON'TO:
❑ EPA
❑ AQMD
❑ ASBESTOS NO'Rfl€:AATtON15NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITCANCELLED
PERM7TEXTENDED
PERMIT FINAL
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OCCUPANCY7S50€O