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Home My WebLink AboutPV2023-0226 - PermitsCity of Newport Beach o Community Development Department- Building Division 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 718-1888 c( newportbeachca.gov/civic IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�� Sour Permit : PV2023-0226 Plan Check No : PC2023-0879 Work Class : Online Issued Date : 06/19/2023 Inspection Area : 1 PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays. Job Address : 1305 BALBOA BLVD E Legal Desc : A TR BALBOA TR EAST SIDE ADD BLK 22 LOT 3 Description : SFR SOLAR PV SYSTEM. 10.8 KW. 27 PANELS Owner: DOSSETT ANDREW J TR Contractor : GREGG MILLER Architect Address : 1305 E BALBOA BLVD Address : PO Box 8071 Address NEWPORT BEACH, CA 92661 REDLANDS, CA 92375 Phone: Phone: Phone: Con State Lic : 657221 State Lic: Lic Expire : 07/31/2024 Applicant: GREGG MILLER Bus Lic : BT30081627 Engineer Address : PO Box 8071 Address REDLANDS, CA 92375 Bus Lic Expire : 05/31/2024 Phone: Workers' Compensation Insurance Phone! Carrier: STATE FUND Owner/Builder : Policy No : 9003703 Designer Address : W. C. Expire : 7/31/2024 Address Phone Code Edition : Type of Construction Occupancy Groups: Bldg Height: Building Setbacks Flood Zone Use Zone 2022 V-B U,R-1 Front: 8, Side: 3, Side: 3, Rear: 0 X R-1 - Single -Unit Residential Processed By: - SPECIAL CONDIT CIVS: Phone: Fire Sprinklers : NO Construction Valuation Fire Hazard Zone : NO No of Units : Type of Solar No of Stories : 2 Kilowatt; 10 $54,400.00 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 io 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 all 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 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). ❑ I, 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 licensors 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:https:llleginfo.legislature.ca.gov. 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: B C10 C39 License Number: 657221 WORKERS' COMPENSATION DECLARATION WARNING: 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 ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 the performance of the work for which this permit is issued. Policy Number: 9003703 0 1 have 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' compensation insurance carrier and policy number are: Carrier: SCIF Policy Number: 9003703 Expiration Date: 01/0112024 Name of Agent: Phone #: 909.798.7457 0 1 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 01 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. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I 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), Lender's Name: Lender's Address: By my signature, I certify to each of the following: RNR ROOFING INC May, 19 2023 I am the property owner or authorized to act on the property owner's behalf. 1 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 to enter the above -identified property for inspection purposes. ova Nam - -- -