HomeMy WebLinkAboutPV2021-265 - Permits11 City of Newport Beach - Building Divistion
v PO Box 1768 Newport Beach, California 92658-8915
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SOLAR Permit: PV2021-265
Permit Counter Telephone (949)644-3288
Inspection RequestsrFelephone (949)644-3255 Project No : 3000-2021
*PV2021-265'
Job Address: 1338 ANTIGUA WAY NB
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CSTEX:l
Issued Date : 02/09/2022
Description:SFR SOLAR PV SYSTEM 9.5 KW. 25 PANELS
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Inspector Area: 3
Legal Desc.: N TR 3852 LOT 47
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Owner: YEAGER JOHN
Contractor:
SEMPER SOLARIS CONSTRUCTION Architect:
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Address: 1338 ANTIGUA WAY
Address:
10713 NORWALK BLVD
Address:
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NEWPORT BEACH, CA 92660
SANTA FE SPRINGS CA 90670
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Phone:
Phone:
619-715-4054
Phone:
State Lic:
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Applicant: ANDREWS SANTO
Con State Lic:
978152
Engineer:
WU HAROLD PING -HUNG
• • •
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Address: 10713 NORWALK BLVD
Lic Expire:
1013112022
Address:
1168 N SAN GABRIEL BL, STE N
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SANTA FE SPRINGS CA 90670
Bus Lic:
BT30075814
ROSEMEAD CA 91770
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Phone: 714-404.5063
Lic Exp Date:
07/31/2022
Phone:
626-288-0708 State Lic:C-035693
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Code Edit : 2019
Worker's Compensation Insurance
Designer:
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Type of Construction: V-B
Carrier:
MIDWEST INS CO.
Address:
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Occupancy Group: R3/U
Policy No:
BNUWC0155108
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No of Stories: 1
Expire:
10/1012022
Phone:
Building Setbacks
Rear:
Use Zone:
Front:
Bldg Height: 0
Left:
Right:
Valutaion : $28,000.00
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: $460.00 Plan Check Fee : $210.00 Fee Due at Permit Issuance : $240.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
PUBLIC WORKS APPROVAL: ,,11
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
INER-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)
ction 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 the applicant for
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 al:d
fessions 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
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do `) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
;iness 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
rovements 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
roved for the perpose of sale).
I, as owner OftfiC property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not
dy t4) an owner of-piroperty who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law).
I am exempt tomlicensure under the Contractors' State License Law for the following reason:
Tr; signature below 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 legall,.
9Structure tl,IaWhave 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
fessions Cdde• �S•dtrailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
mature of Propperty Owner or Authorized Agent Date
TENSED GOIST ACTOR'S DECLARATION
gpy 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 Pro ons Code, and A
license is in full force
Shot.
ONClass • • • License No Date Contractor Signature
�R4RS' COMPENSATION DECLARATION
'NING! FAILUR TO Sh•C11RE 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
'I" COMPEN 4TtON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain 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
erformance of the work 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. workers' compensatioi
c rr er.ccI lic number are: !� /
arrier �•" olicy Number �> /� V V �C-. S�/ � ((1 / Expiration Dra(e 1 0/ 1 0/ (.
ame of Agent • Phone # 6 �`� ,>L-
�t
I certify that, in the performance of the work for which this mit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre
Iat, if I should become act to workers' compensatio p ov' ions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.���
ignature of Applicant D e G
DECLARATION REGA DING CONS.TRUCTION LEMN 114b�AtENCY
hereby affirm under penalty of perj ry that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code).
ender's Name Lender's Address
y 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 co my o finances and state laws relating to building construction.
authorize representatives of this city or count t nter the above ntified grope r inspection purposes. r
ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name D t
441/
ACTION
DATE
BY
DECLARATION OF COMPLIANCE IMTH CODE OF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TIRE 40 AND
AQMD RULE 1403,
PERMIT EXPIRED
❑ 1 SUBMITTED ASBESTOS NOTIFICATION TO:.
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATIONIS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
t/
CERTIFICATEOF
SIGNATURE:.
OCCUPANCYISSUED
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