HomeMy WebLinkAboutPV2021-071 - Permits (3)�xa,rl&r City of Newport Beach - Building Divistion
SOLAR Permit :
PV2021-071
IIIIIIIIIIIIIIIIIIIIIIIIIII
PO Box 1768 Newport Beach, California 92658-8915
Permit Counter Telephone
(949)644-3288
Inspection Requests/Telephone (949)644-3255
Project No: 1044-2021
Job Address: 2601 BLACKTHORN ST NB
Issued Date : 05/1412021
Description:SFR SOLAR PV SYSTEM 35 PANELS 11.543 kW
Inspector Area: 4
Legal Desc.: N TR 4693 LOT 90
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Owner: CNQST LLC
Contractor:
BELMONT ENERGY
Architect:
Address: 2601 BLACKTHORN ST
Address:
27441 MONFORTE
Address:
NEWPORT BEACH, CA 92660
MISSION VIEJO CA 92692
Phone:
Phone:
949-793-5544
Phone:
State Lic:
Applicant: BELMONT JOSEPH
Con State Lic:
963824
Engineer:
TRUONG PHONG
Address: 23291 PERALTA UNIT B2
Lic Expire:
05/31/2023
Address:
20754 TIMBERLINE LN
LAGUNA HILLS CA 92653
Bus Lic:
BT30067504
WALNUT CA 91789
Phone: 949-793-5544
Lic Exp Date:
0513112021
Phone:
949-254-2751 State Lic:C-070784
Code Edit: 2019
Worker's Compensation Insurance
Designer:
BELMONT JOSEPH
....
Type of Construction: V-B
Carrier:
STATE COMP
Address:
23291 PERALTA UNIT B2
Occupancy Group: R31U
Policy No:
9046646
LAGUNA HILLS CA 92653
No of Stories: 1
Expire:
02127/2022
Phone:
949-793-5544
Building Setbacks
Rear: 6' ST.
Use Zone:
Front: 20' VIEW
Bldg Height: 0
Left: 6'
Right: 6'
9 ,t
Valutaion : $69,240.00
Building Permit Fee
$240.00
Record Management (8 1/2 X 11)
$o%b -
Plan Check Fee :
$210.00
Record Management (Plans)
',$$IAl -
TOTAL
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee : $210.00
PUBLIC WORKS
PLAN CHECK BY
APPROVAL TO IS
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID IA
INSTALL OR VERIFY SMOKE AND CARBON MONOXIDE DETECTORS ARE EXISTING PER CRCR 314.1 8 315.2
Fee Due at Permit Issuance
$240.00
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).
❑ 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).
111, 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 Iicensure 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 Code, is available upon request when this application is submitted or at the following Web site:hftp://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 Profes ns ode, nd a is in full force
and effect. �:
License Class GIO GK.� License No qto pi'2. Date (3 Contractor Signature
INORKERS' COMPENSATION DECLARATION
NARNING: FAILURE -C ^171URE 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.:OMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under pcnalty of perjury one of the following declarations:
1J I ha"e 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
-lnance of the work for which this permit is issued. Policy No.
va and will mair:ain 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
of Agent
cert-Fy that, in th= p'=rformance
Policy Number 46 Expiration Date '14 7
2V Phone# co,_99L't7Z-L&
for w Ic ssue I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agre
1, if I should become subject to
kvyv'ulna - cam I provi i ns action 37 he. Labor Code, I shall forthwith comply with those provisions.
I,.ture of Apt, ca,,
CLARATION E AlfDING CONSTRUCTION LENDING AGENCY
areby affirm under p nalty 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).
Ider's Name Lender's Address
my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owners behalf.
I have read this application and the information I have provided is cor
I agree to comply with all applicable city and county ordi u d state ws re to building construction.
I authorize representatives of this city or county to n a e ve- d y for inspection purposes. ^ � D `✓�,Z\
nature of Property Owner or Authorized Age Print Property Owner's or Authorized Agent's Name (—�
ACTION
DATE
BY,
DECLARATION OFCOMPLIANCE tNITNCODEOF
FOR OFFICE USE ONLY
FEDERAL REGULATIONS PART 61 OF TITLE40AND
AQMD RULE 1403.
PERMIT EXPIRED
❑ I SUBmiTTED ASBESTOS NOTIFICATION TO:
❑ EPA
❑ AQMD
PERMIT CANCELLED
PERMIT EXTENDED
❑ ASBESTOS NOTIFICATION IS NOT APPLICABLE TO
PROPOSED DEMOLITION.
PERMITFINAL
fU#L
CERTIFLCATEOF
SIGNATURE:
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