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Home My WebLink AboutX2019-1638 - Permitsnr�y City of Newport Beach - Building Division a 100 Civic Center Drive, Newport Beach, CA 92660 4 r� Permit Counter Phone (949)644-3288 - ar Inspection Requests Phone (949)644-3255 Combination Type - CIP ELEC COMB Permit: X2019-1638 x 2 9 1 9 1 6 3 8 Project No : 1170-2019 Issued Date : 1 011 512 01 9 Inspection Area : 7 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 from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 610 NEWPORT CENTER OR NB ' lN ^ r r ^ Description: COMM - INST &INTERCONNECTION OF TESLA BATTER STORAGE SYSTEM V` It.�..(V' I Uri Legal Desc.: P BK 295 PG 33 PAR 4 - Owner:. IRVINE COMPANY Contractor: RUBICON PROFESSIONAL SERVICES Architect: Address: 660 NEWPORT CENTER DR NEWPORT BEACH, CA 92660 Phone: Applicant: ROESSLEIN JASON Address: 3600 DEER CREEK RD PALO ALTO CA 94304 Phone: 815-814-6347 Code Edit : 2016 Type of Construction: V -B Occupancy Group: S-2 Added /New sq.ft. Bldg: 562 Added /New sq. ft. Garage: 0 No of Stories: 1 No of Units : 0 Bldg Height: 0 Bldg Sprinklers: N Construction Valuation: 455 Building Permit Fee: $3,298.00 Plan Check Fee: $2,869.26 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $32.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $19.00 PROCESSED BY: Address: 3370 CHASTAIN GARDENS DR #220 Address: Fire Inspection: KENNESAW CA. 90144 Fire Plan Rev Phone: 770-485-1013 - Phone: Con State Lie: 986642 Engineer: Lie Expire: 09130/2021 Address: Bus Lie: BT30069327 NMUSD Fee: Lie Exp Date: 10/31/2020 Phone: Worker's Compensation Insurance Designer: Carrier: AMERISURE MUTUAL Address: Policy No: WC210206903 Expire: 07/1512020 Phone: Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant: Grading Permit Fee: Grading PC Fee: WO Insp. Fee: Electrical %: Mechanical %: ___'&mbino %: TOTAL FEE :/$7,749.93 ZONING APPROVAL: GRADING APPROVAL: Rear: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $863.42 $0.00 $0.00 . , State Lie: .... s o GORBIS STANISLAV 1101 MARINA VILLAGE PKWY ° ALAMEDA CA 94501 408-234-3246 State Lic:C-081928 ° 0 0 o mm° oma c a 0 0 aaoto n Special Conditions: ° °C a o ocoo Planning Department - Fire Department Plan check Fee: Fire Inspection: Fair Share ; Fire Plan Rev SJH Trans: Demolition Fee In -lieu Housing Fee Building Dept Adm Public Works Department- Park Dedication : $0.00 PAN Plan Check i $41.25 San Dist: $0.00 NMUSD Fee: $0.00 Plan Check Fee : $3,638.96 PUBLIC Fee Due at Permit Issuance : APPROVAL: PLAN CHE K BY: APPROVAL TO IS! $0.00 $547.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4,210.97 m Gmm°Uo , c mo�cm oa°oo Fire Department $80.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: Fee Due at Permit Issuance : APPROVAL: PLAN CHE K BY: APPROVAL TO IS! $0.00 $547.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4,210.97 m Gmm°Uo , c mo�cm oa°oo 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 L) all of or L) 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 licensure 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 Iegall 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 Cade!is%tailable upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property owner or Authorized Agent D VCENSED Cl9f RACTOR'S DECLARATION I bereF y affirm uticf&penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 0 iv' io 3 of the Business and Profess o 74 cI se is in full force and effect. License Class License No Date 91 Contractor Signature III(ORKERS' QQMPXNSATION DECLARATION A(r✓, FAILURE TO SECLRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLA (E700,0001, IN ADDITION TO THE OST 0 COMPENa4T/OIy DAMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. `MrStly..affirm under penalty of perjury one of the following declarations: I ye andwilt 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 e "Ince of the work for which this permit is issued. Policy No. I. a and Will main iain 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 I lir de carrief'EFI(j pglicy number are: ler "" Policy Number Expiration Date lame of Agent Phone # ]I certify that, in thAperformano k 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 of California, and agre, Iat, if I should becos' compensation provisions of Section 3700 of the Labor Code, I -shall forthwith comply with those provisions. signature of Applica11� DaIECLARATION REION LENDING AGENCY hereby affirm undehere is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ender's Name Lender's Address ly my signature below, I certify to each of the following: I am the property owner or authorized to act on the propey owner behalf. I have read this application and the information I hav&prorreGt. I agree to comply with all applicable city and county ostate laws relating to building construction. I authorize representatives of this city or county toid property for inspection purposes. r1. 'i nature of Property Owner or Authorized Agent Print Property Owners or Authorized Agent's Name • ate 1CTION DATE BY '51EMATIONI OMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONSP T61OFTITLE40ANDAQMDRL PERMITEXPIRED I I I U I SUBMITTED ASBESTOS NOTIFICATION TO PERMITFINAL I,:_s (�7(j �/� UASBESTOS NOTIFICATION IS NOT APPLICABLE TO CERTIFICATEOF Y- PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: