HomeMy WebLinkAboutPV2018-094 - Permits1 City of Newport Beach - Building Divistion SOLAR Permit: PV2018-094
"q PO Box 1768 New port Beach, California 92658-8915 Permit Counter Telephone (949)644-3288
i Inspection Requestslrelephone (949)644-3255
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Job Address: 618 NARCISSUS AVE NB
Description:MFR SOLAR PHOTOVOLTAIC 24 PANELS 8.64 kw
Inspector Area: 5
Owner:
CASSIS ABRAHAM
Address:
618 NARCISSUS AVE
Occupancy Group:
NEWPORT BEACH, CA 92625
Phone:
949-644-9277
Applicant:
MENDOZA MARK
Address:
10192 CONSTITUTION DR
Bus Lic:
HUNTINGTON BCH CA 92676
Phone: 562-447-4971
Legal Desc.: CORONA DEL MAR BLK 641 LOT 20
Code Edit:
2016
Type of Construction:
V -B -SPR
Occupancy Group:
R31U
Phone:
HUNTINGTON BCH, CA 92646
No of Stories:
2
Contractor:
URBAN ENERGY
Address:
10192 CONSTITUTION DR
Address:
HUNTINGTON BCH, CA 92646
Phone:
562-447-4971
Con State Lic:
944115
Lic Expire:
1213112019
Bus Lic:
BT30056602
Lic Exp Date:
0 9/3 01201 8
Worker's Compensation Insurance
Carrier:
STATEFUND
Policy No:
9021421
Expire: 06/01/2019
Building Setbacks Rear:
Use Zone: Front:
Bldg Height: 0 Left:
Right:
Valutaion: $51,840.00
Building Permit Fee $240.00
Plan Check Fee: $210.00
TOTAL FEE: $450.00
PROCESSED BY:
ZONING APPROVAL:
GRADING APPRUdAL:'
GU
Plan Check Fee
$450.00
Architect:
Address:
Phone:
Engineer:
Address:
Illllipiiiiiiiiiigllll
Project No : 1878-2018
Issued Date :0812112018
State Lie: 70,P
Phone:
State Lic:
Designer:
MENDOZA MARK
Address:
10192 CONSTITUTION DR
Phone:
562-447.4971
Record Management (81/2X 11)
Record Management (Plans) :
Fee Due at Permit Issuance
PUBLIC WORKS APPROVAL: g1�r
PLAN CHECK BY:
APPROVAL TO ISSUE
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DW NER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable items)
(Section 7031.5, BusIabSs a 9tl 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 w ith Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt from licensure 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 ow ner of property w ho, through employees' or personal effort, builds or improves the property,
provided that the improvements are not intended or offered for sale. 9, how ever, the building or improvement is sold w ithin one year of completion, the Ow ner-Builder w ill have the burden of proving that
It w as not built or improved for the purpose of sale).
❑ I, as ow ner of the property, am exclusively contracting w ith licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State
License Law does not apply to an ow ner of property w ho builds or improves thereon, and w ho contracts for the projects w ith a licensed Contractor pursuant to the Contractors' State License Law ).
❑ I am exempt from licensure under the Contractors' State License Law for the follow Ing reason:
By my signature below I acknow ledge that, except for my personal residence in w hich I must
have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an ow ner-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 Code, is available upon request w hen this application is submitted. or at the
following Web site�l?tMr/A%ww.leginfo.ca.gov/calaw.html. Signature f Property Ow ner or Authorized Agent
Data
a ( Z1,? LICENSED CONTRACTOR'S DECLARATIOP
• .... • • • • I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectioi
7000J of pivision 3 df tng Business and Professions Code, andmy license is i full force and effect.
• • • • License Class License No Date
"Contractor Signature
WdR�(ERS' COMASNATION DECLARATI
WARM*MfAILURE TO;BMRBWORKERS' COMPENSATION COVERAGE Is NLAW FUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARS ($100,01)(1), IN ADDITION TO THE COS
OF QWSf ATION, DAMAGES AS PROVIDED FOR IN SECTION 37moFTHELABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hei94y.3ftirm under' enalty of perjury one of the follow Ing declarations:
. have 9nd w iRfhltiflt8);n a certificate of consent to self -insure for w orkers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th,
pe drWiCe of the w 4f� for w hich this permit is issued. Policy No.
have and w ill 6iniair w orkers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for w hich this permit is issued. 114 w orkers' compensatio
In rance carrIer and policy number are: r 1
Carrier S�2}2 i oM0 • k>`r' G u(n d. Policy Number Expiration Date
of Agent
certify that, in the performance of the work for w hich this
as that, lt I should become subject to lria kers` c mpem
Iature of Applicant Z/
I hereby
Lender's Name
t is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
provisions of Section 3700 of the Labor Code, I shall forthw ith comply with those provisions. �J d
Date✓
TION REGARDING CONSTRUCTION LENDING AGENCY
under penalty of perjury that there is a construction lending agency for the performance of the w ork for w hich this permit is issued (Section 3097
Lender's Address
By my signature below, I certffy to each of the follow ing:
Civil
I am the property ow ner or authorized to act on the property ow ner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply w dh all applicable city and county ordinances and state law s relating to building construction.
I authorize repraa4mfatives of this city or county ent the �b a- ntified property for inspection purposes. "w
Iature of Property Ow ner or Authorized Print Print Property Owner's or Authorized Agent's Name (h Ul iU�- DafP U ja (/I