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Home My WebLink AboutX2019-0924 - Permitsyaf 1`J9WpPr$.Uggch - Building Division Illllllllllllllllll�llllllllllllllllll�llllllllu COMB Permit: X2019-0924 eQt o 1;00 Grivic Center brio :Mawportbeach, CA 92660 X 2 0 1 9 0 9 2 4 P•ermjt (Ouptel P�oie.r949)664-`•i288 Project No : 0632-2019 9I151pec6on R8quesfa PM hg (949)644-3255 - £a rYfus`' Combination Type - BLDG ELEC Issued Date: 03125/2019 e o m® a • o ®1 a Inspection Area : 8 -e-r-• e�g-a--e-ate • e • e e9. • o m PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION.. • ` • Const;uWiorof'lours;Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 5:00 a.m. to 6:00 p.m. No work on Sundays or Holidays " Job Address: 2271 MESA DR NB Description: SFR - TESLAPOWERWALL BATTERY INSTALLATION .Legal Desc:: TR 706 LOT 164 ALL -EX SELY 82.6 FT. Owner: -PRIMM GARY Contractor: BRIGHT LIFE REMODELING Architect Address: 2271 MESA DR. Address: 933 NEWHALL ST ' Address:. NEWPORT. BEACH CA 92660 - COSTA MESA CA 92627 Phone, 702-575-0504 Phone: 908.489.3911 .Phone: State Lie: Applicant: MEYERS SEAN .Con State. Lice 1029267 Engineer: Address: 933 NEWHALL ST Lie Expire -- -07131/2019 Address: COSTA MESA CA 92627 Bus Lie: BT30060552 Phone: 949-326-3162 Lie Exp Date: 09/30/2019 Phone: State Lie: Code Edit 2016 - Worker's Compensation Insurance - Designer Type of Construction V -B Carrier: STATE FUND Address: Occupancy Group: R31U Policy No: 9053332 Added /New sq:ft. Bldg:. 0 Expire: " 04/19/2019. Phone: _ Added /New sq: ft. Garage: 0 No of Stories: 1 Building Setbacks Rear: / Special Conditions: 5r;K' No. of Units : 1 Front: / Bldg Height: 0 Left: 1. Bldg Sprinklers; Right: I ?11y ` Flood Zone: Use Zone: Parking Spaces: 0 - Fire Hazard Zone: N Construction Valuation: $10.000.00 Building Permit Fee: $232.00 Excise Tax: $0.00 Planning Department - Fire Department - Plan Check Fee: $201.84 Additional Fee ; $0.00 Plan check Fee $40.00. Fire Inspection: $0.00 Overtime Plan Ck: ' $0.00 Grading Bonds Fee: - $0.00 - Fair Share $0.00 '- Fire Plan Rev $0.00. Investigation Fee $0.00 Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: > $0.00 - Grading Permit Fee: $0.00 In -lieu Housing Fee : $0.00 Building Dept Adm $0.00. ,. Energy Compliance: $0.00. Grading PC Fee: $0.00 Public Works Department- General Service. $0.00 CA Seismic Safety.:. $0.00.. WQ Insp. Fee: $0.00 Park Dedication : $0.00 Refund Deposit $0.00 Disabled Access : $0.00 P/W Plan Check: $0.00. Grading Bond: - $0.00. Hazardous Mat $0.00 Electrical %: $30.37 San Dist: $0.00 -Building Green Fee: -.$1.00 Mechanical%: $0.00 - NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL FEE : $505.21 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $505.21 PROCESSED BY: J PUBLIC WORKS APPROVAL: , ZONING APPROVAL: �GITI PLAN CHECK BY: V GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmarkls) j haNpI$cev neRt to jRe 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 iseuanoei also requires the applicant for the permit to file a signed statement that he or is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing All Section DODO) of Division � olthe 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 structureiy"nd: intIrldej or 92erod Tor aalb jSeQtiot 7044,. Business and Professions Code: The Contractors' State License. Law does not apply town owner of property who, through employees' or personal attic builds -or impmves theproperty, provided that the improvements are notintended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will pave t%a burden of proving lhai il As 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 Lawdoes not apply to an owner; of property who. builds or improves thereon, and who contracts for the projects with 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 1 must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal) 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 ofthe Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://Vw .leginfo.ca.gov/calaw.htmi. - Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 700f ivisi 3 of the Business and Professions ode, and license is in full force and effect. License Class License No Dat 4 Contractor Signature r �� 6 e 46104 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 5708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. - I 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, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th rmance of the work for which this permit is issued. Policy No. I h ve and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permitis issued. My workers' compensatio insur nee carrier and policy number are: mer Policy Number Expiration Date Name of Agent Phone #. I 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 of California, and agre that, if I should become sub'er(,t��o the wo�rkpm'�compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicanfi< /l V � �rLM.e� Date: / A I DECLARATION REGARDING -CONSTRUCTION CONSTRUCTION LENDING AGENCY 1 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 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 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 en the above-icleotified property for inspection purposes. Signature of Property Owner or Authorized Agent N Print Pro ert Owner's or Authorized Agent's Nam C� Date 25 ACTION DATE BY DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMDRULE - 1403 PERMITEXPIRED L1 I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA - PERMITEXTENDED QMD PERMITFINAL ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO CERTIFICATE OF PROPOSED DEMOLITION OCCUPANCY ISSUED SIGNATURE: