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Permit No. 2013-27358 ` ' .,' BUILDING DIVISION OF COMMUNITY DEVELOPMENT DEPARTMENT City of Chino Hills rbS`T �, 14000 CityCenter Dr.,Chino Hills,CA91709 c,T1 .,.it Counter Phone (909)364-2780 . £ .,jam . ; Building Permit 24-Hourinspection Lme (909)364-2790 (''''' (NOTE:You must call before 3p m for a next business day inspection) '�. ti (... - - City Hall Main Number (909)364-2600 t ` NOTICE: THIS PERMIT BECOMES NULL AND VOID IF WORK IS NOT COMMENCED WITHIN PLEASE USE PERMIT NUMBER 180 DAYS FROM DATE OF ISSUANCE,OR IF WORK IS SUSPENDED AT ANY TIME FOR MORE BELOW WHEN MAKING INQUIRIES THAN 180 DAYS OR IF WORK IS DONE IN VIOLATION OF ANY CITY OR STATE LAWS OR REQUESTING INSPECTIONS RELATING THERETO. PROJECT DESCRIPTION PROJECT No. PERMIT No. ROOF-MOUNTED PHOTOVOLTAIC WITH PANEL UPGRADE 2013-27358 BUILDING ADDRESS I APT./UNIT NO. I ISSUED GATE x ISSUED BY 13786 VISTA GRANDE DR 6/25/2013 V Whiteman,Rosemary 102410311APN I TRACT MA I LLOT I FLOORS/UNITS I PROJECT PERMITS I P.TYPE 2 / CENCUS CODESr I COONST.TYPE I ZONING TYPE I OCCUPANCY TYPE (VALUATION $5,000.00 I TOTAL SOFT 0001 BLDG.SOFT 434_ Add/A V Current Owners: Fees Name:JACKY CHI-KIN WONG Fee Group/ Fee Description Fee Amount Payments Address. 13786 VISTA GRANDE CHINO HILLS CA 91709 Transaction Type Ph: 909-613-0543 Photovoltaic System $322.09 Email: m@ch org Contractor, MOORE SOLAR&GREEN CONSTRUCTION-MOORE SOLAR&GREEN 8001 Permit Issuance Fee $54.00 54 00 CONSTRUCTION - Address. 13786 VISTA GRANDE DR CHINO HILLS CA 91709 8003 Residential Plan Check Fee $58.34 5834 Ph: 323-221-1260 Email: m@ch.org 839-853 Residential Structural Fee $89.75 89 75 Ue.Informatfon694693 Exp.Date:2/28/2015 UCENSED CONTRACTORS DECLARATIONLICENSED CONTRACTORS DECLARATION 8103 Conduits/Conductors $36,00 36.00 I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9(commencing SB1473 $1.00 1.00 with Sec.7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. In securing this permit I am acting with the knowledge o nd on behalf of the owner of the property. / B100 Svc C/O Up to 200Amps $61.00 61.00 Date 95 .-^0 Comm 261/ OL-Business License Monthly $21.00 21.00 J( _ -- /J Business License SB $1.00 1.00 OWNER-BUILIIER DECLARATION TOTAL FEES $322.09 I hereby affirm under penalty of perjury that I am exempt from the Contractor's Licence Law for the following reason,(Sep7031.5,Business and Profesional Code: Any city or county which requires a AMOUNT PAID $322.09 permit to construct,alter,improve,demolish or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9 commencing with Section 7000 of Division 3 of the Business and BALANCE DUE $0.00 Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption. Any V violation of Sec.7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more that five hundred dollars($500.00) I,as owner of the propterty,or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for sale(Sec,7044,Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale. If however,the building or mprovement is sold within one year of completion,the owner-builder will have the burden of proving that he she did not build or improve for the purpose of sale) I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec,7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractor (s)licensed pursuant to the Contractors License Law). I am exempt under article 3 of the Business and Professions Code. Date. Permittee Print Full Name WORKERS COMPENSATION DECLARATION 1 hereby affirm under penalty, of perjury one of the following declarations I have and will maintain'a certificate of consent to self-insure for workers'compensation,as I certify that I have read this application and state that the above information is correct. I agree to comply provided for by section 3700 of the Labor Code,for the performance of the work forwhich this permit is with all city and county ordinances and state laws relating to building construction,and hereby authorize Issued. representatives of this - to enter upon the above-mentioned proptery for inspection purposes. V_ I have and thewill maintain of the'compensationrwhich insurance,ermias required. Section ef the /') //, - - j ��2��n��� Labor cecamerandlyperformancenumof bkers work forwhich this permit is issuetl. My workers compensation (Act (^J'i1J //JJ„47/ iV insurance caner and policy number ate' t� 4_ J Cartier nOn'Yb/f�w�. Policy 'KPPLICAN GNATURE DA) # A$phcant—Al6MGILES I certty that in the performance of the work forwhich 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 Address: 3820 LOMtTAS DR LOS ANGELES CA 90032-1422 agree that if should become subject to the worker's compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Ph. 323-221-1260 Email' AMY@MOORESOLAR COM Date- ,0 "iii 0. • (3 Lie.Information Exp.Date: Apphcent: f:Z/!(<�/t�T�T/. I certify that the user of this facility shall comply with sections 25506,25533 and 25534 of the Health and WARNING: Failure to secure wq!(f is compensation coverage is unlawful,and shall subject an Safety Code,which regulate the storage,handling and use of hazardous materials employer to criminal penalities.n i civil fines up to one hundred thousand dollars($100,000),in addition to the cost of compensation,da ages as provided for in section 3706 of the Labor Code,interest,and attorneys fees: .