HomeMy WebLinkAboutPV2021-230 - PermitsCity of Newport Beach - Building Divistion
r ; n PO Box 1768 Newport Beach, California 92658-8915
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SOLAR Permit : PV2021-230
Permit Counter Telephone (949)644-3288
Inspection Requests/Telephone (949)644-3255
Job Address: 1221 OUTRIGGER DR NB
Description:SFR SOLAR PHOTOVOLTAIC SYSTEM
11.7kw, (35) ROOF MOUNTED
PANELS
Inspector Area: 6
Legal Desc.: N TR 6634 LOT
44
Owner: SALOMON JIM
Contractor:
URBAN ENERGY
Address: 1221 OUTRIGGER DR
Address:
10192 CONSTITUTION DR
CORONA DEL MAR, CA 92625
HUNTINGTON BEACH, CA 92646
Phone:
Phone:
562-447-4971
Applicant: ALEXANDER MITCH
Con State Lic:
944115
Address: 10192 CONSTITUTION DR
Lic Expire:
1213112023
HUNTINGTON BEACH CA 92646
Bus Lic:
BT30064588
Phone: 530/515-5561
Lic Exp Date:
09/30/2022
Code Edit: 2019
Worker's Compensation Insurance
Type of Construction: V-B
Carrier:
STATE FUND
Occupancy Group: R3/U
Policy No:
9021421
HUNTINGTON BEACH CA 92646
No of Stories: 1
Expire:
06/01/2022
Building Setbacks Rear:
Use Zone: Front:
Bldg Height: 0 Left:
Right:
IIII IIIIII IIIII IIII IIIII IIII IIIIII IIII IIIII IIII IIII
Project No : 2720-2021
Issued Date : 12/14/2021
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Architect:
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Address:
1��ad77
Phone:
State Lic:
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Engineer:
TRUONG PHONG
Address:
20754 TIMBERLINE LN
WALNUT CA 91789
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Phone:
949-254-2751 State Lic: C-070784
Designer:
MENDOZA MARK
Address:
10192 CONSTITRYTION DR -
0
Phone:
562-447-4971
Valutaion : $70,200.00
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 : $210.00 Fee Due at Permit Issuance : $240.00
PROCESSED BY: PUBLIC WORKS APPROVAL:
ZONING APPROVAL: PLAN CHECK BY:
GRADING APPROVAL: _ "APPROVAL TO ISSUE:
a r s e a
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE AND C 4RHON MONO}7DE LsETE(-T(-,RS ARE EXISTING PER CRCR 314.1 & 315.2
)WNER-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 the applicant for
IS 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
'rofessions Code) or that he or she is exempt from Iicensure 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
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,
lusiness 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
nprovements 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
nproved 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
pply 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).
I am exempt from Iicensure under the Contractors' State License Law for the following reason:
ly my 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 le 'I
ell a structure that I have 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html.
lignature of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business andPfession Co e, and my license is in full force
nd effect.
icense Class License No Dat . 'Z 1 �I Contractor Signature
VORKERS' COMPENSATION DECLARATION
IARNING: FAILURE TO 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
DST OF COMPENSATION, 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:
3 1 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 the
e.ormance of the work for which this permit is issued. Policy No.
have and will ma in workers' co nsation insurance, as lquired by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers'
ranee carrier and ollc umber e: r l /
Date
of Agent
11 certify that, in the p�Onnance of the w k 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
tat, if I should become su 1ec to the or s' omp nsatton ovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.XD_11/I 4 I
ignature of Applicant �—f
IECLARATION REGA DI CONSTRUCTION E DING AGENCY
hereby affirm under nalty 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).
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 county 9rdmances and state laws relating to building construction.
I authorize representatives of this city or county a ter a e-id tif' d property for inspection purposes.
ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's Name Date
ACTION
DATE
E ay
DECLARATION OF COMPLIANCE WITH CODE OF
FOR OFFICE USE ONIY
FEDERAL PEGUt OTIONF PART 54 OF TI?L E40 AND'
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUDM.TTEDASCESTCS NORFC ATION TO:
❑ EOA -
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS N077HCA RON IS NOT APPLICABLE TO
PROPOSED DEMOLITIOV.
PERMIT FINAL
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CERTIRCATEOF
SIGNATURE:.
OCCUPANCYISSUED