HomeMy WebLinkAboutPV2023-0528 - PermitsEWn,kr City of Newport Beach
4 d Community Development Department - Building Division
n `yam 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 718-1888
Cq ��OKN`P newportbeachca.gov/civic
IIIlliiiiiiiiiiiii91111
n *�
Sour Permit : PV2023-0528
Plan Check No: PC2023-2439
Work Class: Counter
Issued Date; 10/17/2023
Final Date:
Permit Status: Issued
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 : 20341 BIRCH ST Legal Desc : P BK 340 PG 6 PAR 3
Description: COMM SOLAR PV SYSTEM 27.740 KW 73 MODULES
Owner: BIRCH STREET HOLDINGS LLC
Address : 20341 SW BIRCH ST
NEWPORT BEACH, CA 92660
Phone :
(949) 438-1888
Applicant:
ROBYNPOLUJANCEWICZ
Address :
749 MAIN ST N
ORANGE, CA 92868
Phone:
(949) 438-1888
Owner/Builder :
Address :
Phone:
Code Edition :
Type of Construction
occupancy Groups
Bldg Height :
Contractor:
INFINITY SOLAR
Address :
749 N MAIN ST
ORANGE, CA 92868
Phone:
(657)282-2245
Con State Lic
: 824287
Lic Expire :
09/30/2025
Bus Lic:
BT30060932
Bus Lic Expire : 10/31/2023
Workers' Compensation Insurance
Carrier: STARNET INSURANCE COMPANY
Policy No : BNUWC0160242
W. C. Expire : 7/1/2024
2022 Fire Sprinklers :
V-B Fire Hazard Zone
B No of Units :
No of Stories
Building Setbacks
Flood Zone : X
Use Zone :
Processed By:
SPECIAL CONDITIONS:
NO
NO
3
Architect
Address
Phone :
State Lic
Engineer: NEALWANKET
Address : 1608 W FESCUE LN, #203
COUER d'ALENE, ID 83B15
Phone : (951) 506-6507
Designer: INFINITY SOLAR
Address : 749 N MAIN ST
ORANGE, CA 92868
Phone : (657) 282-2245
Construction Valuation : $88,000.00
Type of Solar
Kilowatt : 27
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I'. am exempt from the Contractors' State License Law for the reasonts) 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
In 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
'mfessions Code) or that he or she is exempt from lieensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a. permit subjects the applicantto a civil penalty of
of more than five hundred dollars ($500).
1 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,
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
mprovements are not intended or offered .for sale. It, 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
poly 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).
7 I am exempt from licensors under the Contractors' Slate 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 legall
all 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:htip:/lwww.leginfo.ca.gov/calaw.html.
Iignature of Property Owner or Authorized Agend_ _ 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 and Professi s d Co, and my license is in AI force
nd effect. License Class License No Date 101 r % 1 2,2 Contractor Signature
VORKERS' COMPENSATION DECLARATION —
'ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
OST 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:
($11K000), IN ADDITION
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
le 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 pem3li is issued. My workers'
rance carrier and policy number are:
ie of Agent
certify that, in the performance of
, if I should became subject tDAKe
of Applicant
Policy Number
Date
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
1)ers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Data_ Ib� 1-1123
areby affirm under penaltVof r' that there Is a const—mZbon lending agency for the performance of the work for which this permit is issued'. (Section 3097
ider's Name Lender's Address
my signature below, 1 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 ordinances and state taws relating to building construction.
I authorize representatives of this city or county to enter the above -identified property for inspection purposes,
nature of Property Owner or Authorzed Agent P 71wn rh aV1SaJ-(,S Print Prooertv Owner's or Authorized Anent'a Name /
ACTION DATE I By DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY
I i REGULATIONS PART 61 OF TITL840 AND AOPND RULE
PERMIT EXPIRED
PERM"T CANCELLED
OE7Mli EXTENDPJ
IfRM,7 FINAL
CE7711-1-ATE OF
M:'IYNCY75SUED
I SUBMITTED ASBESTOS NOTIFICATION TO
L2'ASBEST�OS NOTIFICATION IS OT APPLICABLE TO
PROPOSED DEMOLITION
Civil Code).
(IO-K.t. - 'iA(2s Date to
F
m
W
xz
00
U
/
N
rn
F"
a
U O
p
w
m�
AzrCD
L
0
O CD
Oz�0
w
5-0
Z-
a
(D
�QC7�o
M
•4
X U
W�Amac)
Zw�00
rL
C
U
U
o
0
Z LQ
aO lli7
W
N
Z
LLI
Z
V
J
J
a
H
G
�
°
3
in
U
a'
J
O
W
Z
a
LLI
v
Sa
W
W
W
Z
Yp
O�
0
U
W
a
m
W
En
m
Q
W
o
a
�
N�
Z
Y
O
Q
T
a
'
La
aa.
0
n
N
v
2
-0
v
O
0
0
fn
W
_
C
a
O
D
ra
vi
O
Y
\V
W
Y
2
E
E
Q
o
-
O cc
Z)
o
c
u
H a
•D
W
Q
E
Q
u
e
O
ra
}
U
a
a
a)
Z Li
—
v
L
r6
U
U
N
O
Z
°
a
QJ
Qj
v
cc
.__
L
ra
co
F
N
L
�._
a
L
Q
fu
3
o
Q
ro-
�-
N
a -•
U
i
�
�
m
Z
Q L
c
O
0
�CL
\
>
o��
E 0
+�
N
O
+�
on
o
_0
L
U a
Q
c
Cic
o
-
fu
N
c
+U�
m
a)
m
E
@
Q
a'
0-
y
v
a
U
N
L
N
S
a
E
�
u
"
z
q
_
i
E
-0
s
y
w°