HomeMy WebLinkAboutPV2023-0369 - Permits,✓"EWPO�T City of Newport Beach 1111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII1 Jill Solar Permit : PV2023-0369
p'"<' ecc� Community Development Department- Building Division
100 Civic Center Drive, Newport Beach, CA 92660 Plan Check No: PC2023-1551
Permit Counter Phone: (949) 718-1888 Work Class : Counter
n.wportbeachca.gov/civic Issued Date : 06/27/2023
Inspection Area : 3
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 : 1405 PRISCILLA LN Legal Desc : N TR 1763 BILK LOT 19
Description: SFR SOLAR PV SYSTEM 4.56 KW 12 MODULES
Owner: LA21G LLC
Contractor: T J C HOME BUILDERS LLC
Architect
Address : 26880 ALISO VIEJO PKWY, 200
Address : 26880 ALISO VIEJO PKWY, 200
Address
ALISO VIEJO, CA 92656
ALISO VIEJO, CA 92656
'
Phone: (949)463-1328
Phone: (949)481-7026
Phone:
Con State Lic : 1025507
State Lic:
Lic Expire : 04/30/2025
Applicant: NELLIE MONTEJANO
Bus Lic: BT30059037
Engineer
Address : 26880 ALISO VIEJO PKWY, 200
Address
ALISO VIEJO, CA 92656
Bus Lic Expire : 05/31/2024
Phone: (949) 669-5118
Workers' Compensation Insurance
Phone:
Carrier: TECHNOLOGY INSURANCE CO INC
Owner/Builder :
Policy No: TWC4227597
Designer: COMPLETE SOLAR INC
Address :
W. C. Expire : 3/1/2024
Address : 3000 EXECUTIVE PKWY, 3304
SAN RAMON, CA 94583
Phone:
Phone: (650) 263-8984
Code Edition : 2022
Fire Sprinklers : NO
Construction Valuation : $16,000.00
Type of Construction : V-B
Fire Hazard Zone : NO
Occupancy Groups : U,R-3
No of Units :
Type of Solar
Bldg Height :
No of Stories : 2 -
Kilowatt: 4
Building Setbacks : Front: 20, Side: 6, Side: 6, Rear: 6 i^
Flood Zone : X ELECTP"ii'CAL tvl � rr iL11� T11F3ti u
Use Zone: R-1-600/L/Single-Unit Residential (6000 indicates minimum lot area) (EMS 1S NOT
At-LOWED IF
Processed By: E, �L IC 3 qP?L1CAT`:o�gs
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SPECIAL CONDITIONS:
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 Coda: Any city or county that requires a permit tD construct, alter, improve, demolish, at repair any structure, prior to Its Issuance, also requires the applicant for
is permit tattle a signedstatement that he or sheds licensed pursuant to the provisions of the Contractors' State License Law (Chaptar 9 (commencing Ain Section 7000) of Division of the Business and
'rofessions Code) or Riat he or she Is exempt from lioensure 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 penaltyof
of more than five hundred dollars ($500).
1 I, Be owner of the property, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intended or affered for sale (Section 7044,
iusiness 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
nprovemenls 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
nproved for the purpose of sale).
11, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7944, Business and Professions Code: The Contractors' Stale License Law does not
pply 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).
I I am exempt from licensors under the Contractors' State License Lew for the following reason:
ty 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)
all a structure that. I have built asan 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
'rofessions Code, is available upon request when this application Is submitted or at the following web site:http:/Aw .leginfo.ca.gov/calaw.html..
signature of Property Owner or Authorized Agent i Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm undw penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 the Business and rofess' ,o e d inc at is full force
nd effect Licens sss License No Date Contractor Signatu€
V�)RKURW COIQPEASATION DECLARATION
'ARNING: FAILURE 10 SE.:LRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), 1 N TO THE
CST qF cnMPEaSATION, DAMAGES AS PROVIDED FOR IN SECTION 3709 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury One of the following declarations:
and will r,iain!ain a certificate of consent to sell -insure for workers compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for
ice of ttrs we+ for which this permit is issued. Policy No.
and wit; i,taintain 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' compensa
carrier am! policy number are:
Policy Number
is of Agent
cnl;'y that, in thn performance of the
if I should become subieclteilelao
inture of Aoulican
Date
Led. I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and
of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date
hereby affirm under penalty of perjury that there is a construction lar.10g agency for the performance of the work for which this permit is issued (Section 3097, Civil Code),
enders 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 f have provideAs correct
I agree to comply with all applicable city and county rdinanc s a state t s I rig ullding construction.
1 authorize representatives of this city or coo�iy to e r t a. ,'�{'p,/��'danlifi rty inspection purposes.
�ionature of PrODerty Owner or Authorized Aoenll0 I i Print Property Owner's or Authorized Auent's Name
PERMIT EXTENOEO
CERTIFICATE Of
OCCUPANCVISSUED
OF FEDERAL I FOR OFFICE USE ONLY
REGULATIONS PART bt OF TITLE 40 AW AOMD RULE
I SUBMITTED ASBESTOS NOTIFICATION
PROPOSED O
SIGNATURE:
IS NT APPUCAB'LE TO
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