HomeMy WebLinkAboutPV2021-210 - Permit Application (3)t,rl City of Newport Beach - Building Divistion
i " 1 PO Box 1768 Newport Beach, California 92658-8915
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SOLAR
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Job Address: 2011 YACHT DEFENDER NB ��yx
010
Description:SFR SOLAR PHOTOVOLTAIC SYSTEM 33 PANELS 13.2 kw ," Q /
Inspector Area: 6
Owner: BORREGO ALEXANDRA
Address: 2011 YACHT DEFENDER
NEWPORT BEACH, CA
Phone
Legal Desc.: N TR.9260 LOT 67
C6ntractor: SPS ELECTRJ�
Address 2 SAMP O AVE, STE 113
tea' CORONA C 92879
Pho 714 261-5180
Applicant: FLORES RUBY 'Or on State Lic: 1008748
Address: 116 QUARRY ST J' Lic Expire 11130/2021
CORONA, CA 92879 ya Bus Lic BT30063780 A c
Phone: 714-261-5180 ^/ Lic Exp Date. 07131/2022
Code Edit: 2019 w Worker's Compensation Insurance ' A
Type of Construction: V-B +, r Carrier CAROLINA CASUALTY S C41
Occupancy Group: R3/U } Policy No'. BNUWC0154080
No of Stories: 0 ; Expire 05/01/2022
qL• �+ Building Setbacks Rear.
Use Zone: &� �.d.i Front:
Bldg Height: all) ,� � ..�r',` Left:
'� Right. 9 .
v�_ frF
Valutaion : $79,20.0.00
Building Permit Fee
Plan Check Fee
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Project No : 2521-2021
Architect:
Address: ., n \CJ
Phone:r� 0J,
31
116 QUAPW ST
QQ3NA0tA 92879
Illlliipiiiiiiiiiiiiiiiiiiiiiiigi!i91111
Issued Date y111129TD
NO �iCJ
X24
State Lic:C-058724
iN'3PE%G-TOR
���® Record Management (8 1/2 X 11) $0.00 Record Management (Plans) $0.00
e:
�SPIan Che Fe10.00 Fee Due at Permit Issuance : $240.00
PUBLIC WORKS APPROVAL:
CC PLAN CHECK BY: `�Fi�-•
... APPROVAL,TO ISFL'E:
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.
INSTALL OR VERIFY SMOKE AND CARBON MONOXIDE DSTE;T 3RS=ARE-EX/S`ING rGR CRCR 314.1 & 315.2
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the sons) in
ction 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alt ,Improve, Be
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contrac 'State License
fessions Code) or that he or she is exempt from Iicensure and the basis for the alleged exemptio ny violation of Sej
more than five hundred dollars ($500). t(a
I, as owner of the property, or my employees with wages as their sole compensation
iness and Professions Code: The Contractors' State License Law does not apply to
rovements are not intended or offered for sale. If, however, the building or imp
roved for the purpose of sale).
U I, as owner of the property, am exclusively contracting with licensed
apply to an owner of property who builds or improves thereon, and who
❑ I am exempt from Iicensure under the Contractors' State License LE
By my signature below I acknowledge that, except for my personal re
sell a structure that I have built as an owner -builder if it has not be co
Professions Code, is available upon request when this cawn cawis Sul
Signature of Property Owner or Authorized Agent
LICENSED CONTRACTOR'S DECLARATION
to
for
the checkmark(s) I have placed next to the applicable item(s)
any structure, prior to its issuance, also requires the applicant for
(commencing with Section 7000) of Division 3 of the Business and
rNpplicant for a permit subjects the applicant to a civil penalty of
_) all o -or U p0 Ns of the work nil tAl
odf�•rty wttgoughP mpl ees' or pl
VV ��*�i(((hhtttlln(op@ tt ee��dr of com I n, the Own(
he,pr j%, Section 44, Business and P
9 licensed C tractor pursuant to the
is not intended or offered for sale (Section 7044,
)rt, builds or improves the property, provided that the
Whave the burden of proving that it was not built or
the following re(a,$p)P
in which I mus[`pBVe nesikokwr at least one year prior to completion of the
:te n its entirety by licecontractors. I understand that a copy of the al
or at ",following i/pb site:http://www.leginfo.ca.gov/calaw.html�
I hereby affirm under penalty of perjury that I am lice d undejpr elisions of Chapter 9 (commencing with Section 7000) of Divisio�e(tlilBusiness
and effect. �, `++
License Class Icense a Date Q ZOZ o rac�f,or Signature
VORKERS' COMPENSATION DEC TION 0
IARNING: FAILURE TO SECURE WORKERS' C ENSATION C ERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN Lit No FINES UP TO
:DST OF COMPENSATION, DAMAGES AS P IDED FOR IN CTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of ury one of e following declarations: �✓ (�.��
I have and will maintai certificate f consent to self -insure for workers' compensation, issued th ctor Rdustrial R ions
erformance of the work which this rmit is issued. Policy No. ,p
�ave and will tarn wQ s compensation insurance, as required by Section 3700 of the L r e, foriha perform ce pf�flb%w
lsllf9nce camef,. d poliCYlltUn er are. ``
Te of Agent
certify that, in the+ ana
, if I should beco' Ubl t to
iature of Applicant
Policy Number
O
of thework for which this permit)! issue
is ;kers ccoTpensauo�ff{�}o�krovisions of
%GVGS�UiA V�kL r4
LSTIRLIG94IRMN01111nill AGENCY
hereby affirm under penalty's erj artXeJoEnstruction 11 ndilf, I
ender's Name
y my signature below, I certify to a:, ch' he fo wing:
I am the property owner or authii ` ad t ct on the p y dM er's�§�
I have read this application and th for ion I ad is act
I agree to comply with all applicable An ount Bees and state
I authorize representatives of this city' ou0 o er)J r the above-identif
ignature of Property Owner or Authorized
WITation Date
shone #
Contractors' State License Law does not
ense Law).
7044 of the Business and
my license is in full force
DOLLARS I$100,0001, IN ADDITION TO THE
for by Section 3700 of the Labor Code, for
which this permit is issued. My workers'
I shall not employ any person in any fiianner Silas rbecome subject to the workers' compensation laws of California, and agree
ctio 37R0-of the Labor Code, 1 all forth) i ply with those provisions. �7
a Dat:� ��/��/ZG
ncyS&1,11e performa a of the or r which this permit is issued (Section 3097, Civil Code).
Lender's Bess
a
f. Oldj .
IS elating u g construction.
propert or pection purposes.
al. Print Property Owner's or, Authorized Agent's Name \/7G'/OGG9'Gl/1 / �H Date 2Z
ACTION
DATE
CLARATlON' OF COMPLIANCE INITH CODE OF
FOR OFFICE USE ONLY
i
FEDEi'AL REC!ILATMNS PART 61 OF T17LE40 AND
AQMD PULE 1403.
PERMdTEXPIRED
,�
G I SL:BM1RTTEDAS3ESTOS NOTIFICATION TO:
C EPA
❑ AQMD
PERWTCANCELLED
PERMITEXTENDED
""
❑ ASBESTOS N07IRCA'RON IS NOT APPLICABLE TO
PROPOSED,=MCLITION.
PERWITI
�8-Z2
CERTI'-)GATE PF
_
SIGNATJRc:
OCCUPANCYISSUED
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