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Home My WebLink AboutPV2021-214 - Permitsawhr/ City of Newport Beach - Building Divistion G PO Box 1768 Newport Beach, California 92658-8915 y r'1 [lYi)tiH+h SOLAR Permit: PV2021-214 Permit Counter Telephone (949)644-3288 Inspection Requests/Telephone (949)644-3255 Job Address: 3900 E COAST HWY NB Description: COMM SOLAR PV SYSTEM, 10.14 KW. 26 MODULES Inspector Area: 7 Legal Desc.: TRACT NO 673 BILK B LOT 54 AND POR ABAND ALLEY Owner: MADGI HANNA Contractor: SOLAR OPTIMUM INC Architect: Address: 3345 NEWPORT BLVD STE 203 Address: 501 WEST GLENOAKS BLVD #565 Address: NEWPORT BEACH CA 92663 GLENDALE, CA 91202 Phone: Phone: (818)804-3122 Phone: Applicant: RAMIREZ JERRY Con State Lic: 972228 Engineer. Address: 614 W COLORADO ST Lic Expire: 04/3012022 Address: GLENDALE CA 91204 Bus Lic: BT30063259 Phone: 323-620-3357 Lic Exp Date: 05/31/2022 Phone: Code Edit: 2019 Worker's Compensation Insurance Designer. Type of Construction: V-B-SPR Carrier: STATE COMP Address: Occupancy Group: B Policy No: 9013440 No of Stories: 2 Expire: 05/18/2022 Phone: Building Setbacks Rear: Use Zone: Front: Bldg Height: 0 Left: Right: Valutaion : $20,280.00 Building Permit Fee $580.00 Plan Check Fee : $420.00 TOTAL FEE : $1,000.00 Plan Check Fee : $420.00 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: *PV2021-214* Project No : 2579-2021 Date : 04/1312022 State Lic: TRUONG PHONG 20754 TIMBERLINE LN WALNUT CA 91789 ' 949-254-2751 State Lic:C-070784 BEAM RALPH W 11223 MILDRED ST EL MONTE CA 91731 " 626.361-6170 Record Management (8 112 X 11) Record Management (Plans) : Fee Due at Permit Issuance PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. $0.00 $0.00 $580.00 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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 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 L) all of or L) 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-Builderwill have the burden of proving that it was not built or improved 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 Cade: 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 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, sell 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 Professions Codeis available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/caiaw.html. Signature of Property O.vner or Authorized Agent Date I ICENSED CONTRACTOR'S DECLARATION I 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 and Professi ns Code, and my license is in full force and effect !.icerss Class License No Date 13 2 Contractor Signature WORKERS' 00NIPENSATION DECLARATION `NARNTG: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 15 UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDR THOUSAND DOLLARS IS100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. herebl affirm I^aer penalty of perjury one of the following declarations: I. have and wh,l 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 prmance of the work for which this permit is issued. Policy No. 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' came, anc policy number are: ne of Agent certify that, in the performal if I should become subject iature of Applicant Policy Number Date 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 workers' c tion provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date (0/22- =reby affirm under penalt444,bf perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ider's Name ,, Lender's Address 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 ordina es and I authorize representatives of this city or county enter ove-i nature of Property Owner or Authorized Agent ACTION I DATE I V BY PERMIT EXPI RED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTF`CA TE OF OCCUPAIVCYISSUED I to building construction. for inspection purposes. Print Property Owner's or Authorized Agent's FEDERAL REGULATIONS PART 61 OF TITLE40AND AQMD RULE 1403. ❑ / SUBMITTED ASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD ❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: