HomeMy WebLinkAboutPV2023-0558 - Misc�IZDZ�-bs'S �
CITY OF NEWPORT BEACH
' �" �FCOMMUNITY DEVELOPMENT DEPARTMENT
' ` n BUILDING DIVISION
U = 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
cg4FORH�r www.newportbeachca.gov 1 (949) 644-3200
SOLAR CONTRACTOR DECLAMATION
PART 1: To be completed BEFORE PERMIT ISSUANCE
JOBSITE ADDRESS:
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CONTRACTOR NAME:
CONTRACTOR STATE LICENSE #:
OA(O"c, L-VLCX-SY
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PANEL MAKE #:
PANEL MODEL #:
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PART 2: To be completed PRIOR TO INSPECTION REQUEST
and placed with jobsite inspection card
DECLARATION:
I, H declare that the PV module make and model
(P21NT AME)
number, quantity, and location are installed as per the approved plans. Module
manufacturer, make, model and number, fire classifications of modules, and
brackets match the appr ved plans for the project located at the above
referenced add s with' the City of Newport Beach.
(SIGNATI)RP) (DATE)