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101107763 - Permit
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101107763 - Permit
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Entry Properties
Last modified
10/26/2021 7:38:54 AM
Creation date
10/26/2021 7:38:53 AM
Metadata
Fields
Template:
Permit
Permit Number
101107763
Full Address
1851 W Meadowbrook Dr
Permit ID
278763
Master ID Number
2021-168416
Project Name
Miscellaneous Counter1 Permit
Street Number
001851
Street Direction
W
Street Name
Meadowbrook
Street Suffix
Dr
Building Use Code
Resid-1 unit
Job Types
Solar
Permit Type
Building
Applied Date
8/25/2021
Issued Date
9/7/2021
Finalized Date
10/18/2021
Flood Zone
X-0602320259J
Description of Work
Install new roof mounted solar PV system. Per PV checklist.
Nature of Work
Solar
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BUILDING. INSPECTOR RECORD <br />SITE.WORK DATE ID/SIG.COMMENTS OWNER BUILDER DELCARATION <br />I hacby a(fim undc pcrulty of pcrjury that I m cxcmpt fiom thc Contrectos' LicN trw for thc following rwn (Se.7031.5 <br />Buinqs md Profcssion Code): Any City or Couty which rcquire a pemh to coNtruct, alto. improvq danolish or rtpoir my <br />struc1uc, Srior to its isuucc, also requirs rhc applicmt for such pcrmit to file a signcd statmot that hc or shc is liccnscd psuilt <br />to thc irovisios of thc Contractor's Licmscd Law (Chapts 9. Comcncing with Setion 7000 of Division 3 of thc BNin* ild <br />Prcfc$ionsCodc)orthathe orsheisexmptthocfromudthcbasisforthcallcgedq@ption. AnyviolationofScclion?03l.5byuy <br />applicatforapcntritsubjctsthc applicettoacivilpcnaltyofnotmorcthilfrvchun&cddollus($500). <br />_1, as owner of the property, or my employecs with wagcs as their sole compensation, will do the work and the structure is not <br />intended or ofFered for sale (Sec.7M4, Business and Professions Code: The Contractor's License [^aw does not apply to an owner of <br />the property who btrilds or improves thereon, and who does such work himself or herself or through his or her own cmployees, <br />provided that such improvonents are not intcnded or offered for sale. If. howe'ver. the building or improvement is sold within one y€ar <br />of complaion, the Owner Builder will have the burden of proving thd he or she did not build or improve the propoty for the purpose of <br />sale). <br />_1. as owner of the property. am exclusively contracting with liccnsed contractors to construct the project (Sec. 7O44, Business <br />and Pnofessbn Code: The Contractor's License Law does not apply to an owner of property who builds or improves ther@n. <br />and who contracts for such projects with a Contracto(s) licerscd pursuant to the Contractor's Licensc l-aw). <br />-l <br />am exempt under Section-. B. & P.C. for this reason. <br />Owner: <br />WORIGRS'COMPENSATIM <br />DECLARATION <br />I hereby affrrm under poralty of perjury one of the following declarations: <br />_l have and will rnaintain a Certificate of Consent to Self-lnsure for workers'compensation, as provided for by Section 3700 of the <br />ffi;for the performance ofthe work for which the pennit is issued. <br />rvill rnaintain workers'3700 of the Labor Code. for thc performancc of <br />this permit is and policy number are: <br />Policy <br />_l certify that in thc performance of the work for which this permit is issued, I shall not crnploy any person in any manner <br />so its to become subject to the workers'compensation laws of California. and agree that if I should become subject to the <br />workers' compensation provisions of Section 3700 of the Labor Code, I shall, forthwith comply with thosc provisions. <br />WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an onployer to crfuninal pcnalties and <br />civil fines up to one hundred thousand dollars in addition to the of cornpensation, damages as provided for the <br />Section 3076 of the Code. interest and <br />DECI.ARATION <br />I hereby affrrm under poralty of perjury that I arn licenscd under p,rovision of Chapto 9 (cornmencing with Section 7000) of Division 3 <br />of the Business and Professions Code. and my license is in full force and effect. <br />2 <br />License Number: <br />I <br />W <br />I hqeby affirm under pqElty of psjury that th@ is a coGtruction lmding agency for the pqfommce of thc work for which this pqmit b <br />issuel (Sa. 3097, Civ. C.). <br />Lender's Name: <br />Lendcr's Address: <br />A PPLTCAI\T DEC T.ARATION <br />I ha€by alnrm under pcnalty of perjury one of the following declarations: <br />Demolition Permits-Asbestos Notification Federal Regulations (Title 40, Part6) <br />-Required <br />Lcttcr of Notification <br />J coti$ that the federal regulations regarding asbcstos rcmovalare not applicable to this project. <br />(-r/"*ig/ <br />that I have read this application and statc that the abovc information is correct. I agrce to comply with all City and County <br />ordinances and State Laws relating to building City and County to enter upon the <br />above mentioncd property for <br />Applicant or Agent <br />Permitee name (print): <br />purposes. <br />and hereby authorize <br />,,,",qf z/>-l <br />Set Backs <br />Forms/Steel/Holdowns <br />Erection Pads <br />UFER Ground <br />SLAB Floor <br />Su bfloor/Venul n su lation <br />Roof Sheathinq <br />Shear Wall <br />Framinq <br />lnsulation/Enerqy <br />Drywall <br />Ext./lnt. Lath <br />Brown Coat <br />Masonrv <br />Pool Fence <br />T-Bar <br />Handicap Req <br />Deputy Final Report <br />Engineer Final Report <br />Flood Zone Certif. <br />*-a- Canrrra 4r h, -J $ -zt B^f {e <br />FINAL te-ll-2|Degtr? {r <br />Certificate of Occupancy <br />Notes, Remarks, Etc. <br />Date:
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