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Home My WebLink AboutPV2021-141 - PermitsJ� P,� , City of Newport Beach - Building Divistion SOLAR Permit: PV2021-141 11�1111�1Ip11111111111111p111111111111111111p1111lJill . PO Box 1768 Newport Beach, California 92658-8915 Permit Counter Telephone (949)644-3288 s:.. Inspection Requests/Telephone (949)644-3255 �'�a�,�a�� :' Project No: 1840-2021 Job Address: 4500 ROXBURY RD NB Issued Date : 05/26/2022 Description:SFR SOLAR PV SYSTEM- 30 MODULES 11.1 KW Inspector Area: 5 Legal Desc.: N TR 3357 LOT 11 - - -- . - - Owner: ROWSHAN KASRA Contractor: FREEDOM FOREVER LLC Architect: - Address: 4500 ROXBURY RD Address: 7200 FENWICK LN Address: CORONA DEL MAR, CA 92625 WESTMINSTER CA 92680 Phone: Phone: 888-557-6431 Phone: State Lic. -- •- Applicant: AVILEZ ALEXANDRO Con State Lie: 1029644 Engineer: Address: 7200 FENWICK LN Lie Expire: 08/31/2023 Address: WESTMINSTER CA 92683 Bus Lie: BT30064271 Phone: 888-557-6431 Lie Exp Date: 08131/2022 Phone: State Lie: Code Edit : 2019 Worker's Compensation Insurance Designer: ALBRIGHT G"G Type of Construction: V-B-SPR Carrier: BERKSHIRE HATHAWAY HOMESTATE Address: 43445 BUSINESS PARK DR #110 Occupancy Group: R3/U Policy No: FRWC217374 TEMECULA CA 92590 - No of Stories: 1 Expire: 06/01/2022 Phone: Building Setbacks Rear t , Use Zone: Front: Bldg Height: 0 Left: Right: Valutaion: $30,000.00�-.,. Building Permit Fee $240.00 Record Management IS 112 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: PUBLIC WORKS APPROVAL: ZONING APPROVAL: lA PLAN CHECK BY: (� JY ►y/fie GRADING APPROVAL: om o o• 00 0 0 o • • • e •oo APPROVAL TO ISSUE: 0 c o0 0�0 0 o D o e 0 oPERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. m JN93ALL DR VF;RIFYe4MQK5 AND CARBON MONOXIDE DETECTORS ARE EXISTING PER CRCR 314.1 & 315.2 e o D o m e o 0 0 ® o 00 v ®m • o )MINER -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). I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U 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' State License Law). ❑ 1 am exempt from Hcensure 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 legally 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 Cade, 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 Professions Code, and my license is in full force and effect.—�� License Class �l%GIO�(HIr�G?v °i License No 62T6 Da t . Z 2A2_Z Contractor Signature WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 111 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 thl p�1� mance of the work for which this permit is issued. Policy No. 5 ha a and will maintain 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' compensatior insure ce1�carr1i'er and policy number are: y7 2 er UGdI(b�ML �[L�iLyQV {'�aru jM� Policy Number / 66 C2i �J7% Expiration Date W_�V Name of Agent n Phone # ❑I 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 agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant ,1 � J �— O j 26 Zoz.2 DECLARATION REGARDING CCAKRUCTION LE I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By 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 o unty to enter the above -identified for inspection purposes.gi.ar� C`2 26 Signature of Property Own or uthorized Agen Y/} Print Property Owner's `_I/Authorized Ag`ent'i Name F Gl Date � %'ce� ACTION DATE BY DECLARATION OF comPL7AN77IwrrFr3FF6vF FOR OFFICE U5F ONLY \\ FEDERAL REGULATIONS PART 61 OF TITLE404ND AQMDRULE1403. • • ••• :•• ••• �•• �•• P ERMITEXPIRED ❑ 1ffUBMITTEDASBESTflS NOTIFICATION T;7:: • ❑ EPA • . • ... ❑ AQMD • •. ' . • • .. PERMIT CANCELLED PERMITEXTENOED ❑ ASBESTOS N07IRCA77ON IS NOT APPLICABLE TO PROPOSED DEMOLITION. ... . a • . • • • • .. e• e e e n e e PERMIT FINAL CER77FICATEOF SIGNATURE.,OCCUPANCYISSUED