HomeMy WebLinkAboutPV2022-0303 - Misc�F W PART
ot, .i @ CITY OF NEWPORT BEACH
y COMMUNITY DEVELOPMENT DEPARTMENT
n BUILDING DIVISION
U' 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
ciFoa� P www.newportbeachca.gov 1 (949) 644-3200
SOLAR CONTRACTOR DECLARATION
Keep with Inspection card
JOBSITE ADDRESS:
2-3 i 61,11q c %I V--
CONTRACTOR NAME: CONTRACTOR STATE LICENSE
i #:
s C I
PANEL MAKEPANEL MODEL #:
a ic.(C- t ( -� b
PART 2: To be completed PRIOR TO INSPECTION REQUEST
and placed with jobsite inspection card
DECLARATION:
I'-J6t'/�C)(xh /U/ku?S declare that the PV module make and model
(PANT NAME)
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 approved plans for the project located at the above
referenced address within the City of Newport Beach.
0
(DA I L)