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Home My WebLink AboutPV2019-191 - PermitsCity of Newport Beach - Building Divistion PO Box 1768 Newport Beach, California 92658-8915 Job Address: 2805 BALBOA BLVD NB Description:MFR SOLAR PHOTOVOLTAIC SYSTEM 20 PANELS 8 kw Inspector Area: 1 Legal Desc.: Owner: UYEN NGUYEN Contractor: Address: 18700 BEACH BLVD Address: HUNTINGTON BEACH, CA 92648 Phone: Phone: SOLAR Permit: PV2019-191 Permit Counter Telephone (949)644-3288 Inspection Requestslrelephone (949)644-3255 URBAN ENERGY 10192 CONSTITUTION DR HUNTINGTON BEACH, CA 92646 562.447.4971 Applicant: ALEXANDER MITCH Con State Lie: 944115 Address: 10192 CONSTITUTION Lie Expire: 12/31/2021 Designer: HUNTINGTON BEACH, CA 92824 Bus Lic: BT30064688 Phone: 530-515.5561 Lie Exp Date: 09130/2020 Code Edit : 2016 Worker's Compensation Insurance Type of Construction: V -B Carrier: STATE FUND Occupancy Group: R31U Policy No: 9021421 No of Stories: 2 Expire: 06/0112020 Building Setbacks Rear: Use Zone: Front: Bldg Height: 0 Left: Right: Project No: 2723-2019 Issued Date : Architect: Address: Phone: State Lie: Engineer: TRUONG PHONG Address: 20754 TIMBERLINE LN WALNUT CA 91789 Phone: 949-254-2751 State Lic:C-070784 Designer: Address: NO WNSTRUCTION NOISE P2 0 1 9 1 9 1��iiiii Valutaion: $48,000.00 Building Permit Fee $240.00 Record Management (8 1/2 X 11) $0.00 Plan Check Fee: $210.00 Record Management (Plans) $0.00 TOTAL FEE: $450.00 Plan Check Fee: $210.00 Fee Due at Permit Issuance : $240.00 PROCESSED BY: < r PUBLIC WORKS APPROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: OPPRPVAL 71Q ISU: 0 0 0• • • o • e c m •m •0 0 o m o mmm • • •m o PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. INSTALL OR VERIFY SMOKE AND CARBON MONOXIDE tO,)ETECtOf2S°•A11E FX(STIN(4 PER CRCR 314.1 & 315.2 o • • m• • •• m m m c c OWNER -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 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 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). ❑ 1, 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 -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ 1, 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 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' Slate License Law). ❑ 1 am exempt from licensure 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 Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED 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 Prof ssions Code, and my lic nse is in full force and effect. / License Class License No DateVVV r !� i Li. Contractor Signature.. /44M. , COMPENSATION DECLARATION IARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 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: DOLLARS ($100,000), IN ADDITION TO THE I have 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 ;ormance of the work for which this permit is issued. Policy No. have and will m�+ n 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' rance carrier and'yLolic number are: A _ /1 _ Date lame of Agent t lJYW I Phone # 11 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 workers' compensation laws of California, and agre rat, if I should become su ject to he workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ignature of Applicant All si o& Da IECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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). Ender's Name Lender's Address �y 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 ordinances and state laws relating to building construction. I authorize representatives of this city or county o ter a bov -id tified property for inspection purposes. �A �� ,/ _ D j� �. ignature of Property Owner or Authorized Agent aed / `9 Print Property Owner's or Authorized Agent's Name 1`�1 V6 / AC770N DATE BY UtLLAHA I ANN Ut- LUMYLtAPILL YYII n LU"L Ur 117RUPtILt uSt UIVLY • . FERERA k PEGULATIONSPART 61 OF T/ TL E 40 AND PERMITEXPIRED jAQAV RU4E?40; {ji UBf�TT£Dk_W74S N071FIC477ON TO., PERMITCANCELLED • 8 A PERMITEXTENDED ❑ AQMD 0 ASBESTOS M07 PERMITFINAt 7 M. —/-20 � •PROPOSEODEMOkIMA71ONT5NOT APPLICABLE T0 CERTIFICATE OF • • • p• • •• • • OCCUPANCYISSUED • • �ITN��fi%A • 6if7s. !.`sL/