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Home My WebLink AboutPV2023-0492 - PermitsW �R City of Newport Beach jj�IIIIIIoIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII� jj sour Permit : PV2023-0492 6' Community Development Department- Building Division P 2 m 2 3 m 4 9 z >`- 100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No : PC2023-2225 Permit Counter Phone: (949) 718-1888 Work Class : Counter newportbeachca.gov/civic Issued Date: 09/21/2023 Final Date: Permit Status: Issued Inspection Area : 7 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays. Job Address: 4611 TELLER AVE Legal Desc : P BK 125 PG 3 PAR 1 Description: COMM SOLAR PV SYSTEM 82.84 KW WITH 152 MODULES AND 38 MICROINVERTERS. Owner: BARRY SAYWITZ PROPERTIES ONE LP Address: 4740 VON KARMAN AVE STE100 NEWPORT BEACH, CA 92660 Phone: (949)636-1467 Applicant : NATIONAL ENERGY INSTALLERS LLC Address : 2801 COAST HWY W NEWPORT BEACH, CA 92663 Phone: (949)386-4428 Owner/Builder Address : Phone Contractor: NATIONAL ENERGY INSTALLERS LLC Address : 2801 COAST HWY W NEWPORT BEACH, CA 92663 Phone: (949)386-4428 Con State Lie: 1038437 Lie Expire : 12/31/2023 Bus Lie : BT30069480 Bus Lie Expire : 10/31/2023 Workers' Compensation Insurance Carrier: SIRIUSPOINT AMERICA INS CO Policy No : WC10670400 W. C. Expire: 10/9/2023 Code Edition : 2022 Fire Sprinklers : Type of Construction : V-B Fire Hazard Zone Occupancy Groups : U,B No of Units : Bldg Height: No of Stories Building Setbacks : Flood Zone : X Use Zone : PC - Koll Center Processed By: SPECIAL CONDITIONS Architect Address Phone: ' State Lie Engineer: RYAN MCPHERSON Address : 9240 LIMONITE AV JURUPA VALLEY, CA 92509 Phone : (909) 569-2244 Designer: NATIONAL ENERGY INSTALLERS LLC Address: 2801 COAST HWY W NEWPORT BEACH, CA 92663 Phone: (949)386-4428 NO Construction Valuation : $130,000.00 NO Type of Solar 2 Kilowatt : 82 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the ContractorsState License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items) (Secfion 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after. improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant 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 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 not 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 (_) 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 improved for the purpose of sale). El i, as owner of the properly, 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 exempt from Iicensure under the Contractors' State License Law for the following reason ...... By my signature below f 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 legally soil a structure that I have built as an owner -builder if it has not been constructed in its entirely by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Codg.. is available upon request when this application Is submittedor at the following Web site:http://www.leginto.ce.govIGalaw.htmi, Signature of Progeny Owner or Authorized Agent - Date LICENSED CONTRACTOR'S DECLARATION I herby affirm ucde� penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7 00) of Division 3 Of the Bu es and Profes s Cod my license is In full farce and effect. License Class License No Da Contract rSignature VVORXERS' COMPENSATION DECLARATION \ WARNING: FAILURE Tr• SLCURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT" EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADOMON TO THE 'OST OF COMPENOti_TION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ FEES. I heaby affirm under },enalty of perjury one of the following declarations: G I h,^ve and will maintain a cerlifrcate, 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, rmance of the work for which this permit is issued. Policy No. hava and 011 Ir.air,lain 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' compensatior m urance carrier and poilcy number arw t.amiervi a1,N „^2-/L•C Policy Number 1038c137 Expiration Date IU 3U Z3 AName of Agent }],d201.7 A4; �rZ Phone # /ter 2 7 Y - 8 114—f t 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 wor ers' mpensation laws of California, and agree that, if I should become s b' et to the wor rs' compensation provisions of Section 37DO of the Labor Code,. I shall forthwith comply with those provisions. Signature of Applic ING AG _ Date 9' 2 1- Z DECLARATION RUI G C NSTRU TION LENDENCY——""___..._._.._.__ 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). Lenders Name Lender's Address By my signature below, I certify to each of the following: I am Ilia 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 cit. r c my nter th ove-identified property for inspection purposes !� Signature of Property Owner of Authorize gent �-- '� Print Property Owners or Authorizad e VsName K-l21S K fQ /Z to ACTION DATE Y F DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY i REGULATIONS PART 61 OF TITLE 40 AND ACIMD RULE PERMIT EXPIRED 9 L.J I SUBMITTED ASBESTOS NOTIFICATION PERMIT CANCELLED EPA PERMlTEXTENDED fUAOMD ND'IVICATION I5NOT' APPLICABLE TO CERTINCATE Of / PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: