HomeMy WebLinkAboutX2019-3805 - Permitsg,111o4 City of Newport Beach - Building Division
�.. 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3288
s ' $ Inspection Requests Phone (949)644-3255
Combination Type - SFP ELEC
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB Permit: X2019-3805
Project No: 2616-2019
Issued Date : 1112 7/2 01 9
Inspection Area : 6
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: 6 ANACAPRI NB
Description: SFR ENERGY STORAGE SYSTEM (13.5 KWH)
Legal Desc.: N TR 15493 LOT 8
Owner:
TSAI JEROME
Contractor:
TESLA ENERGY OPERATIONS
Architect:
Address:
6 ANACAPRI
Address: -
2012 ALTON PARKWAY #B
Address:
10/31/2020
NEWPORT COAST, CA 92657
Additional Fee :
IRVINE CA 92606
No of Stories: 2
Phone:
Rear: I
Phone:
650-638-1028
Phone:
Applicant:
TESLA ENERGY OPERATIONS
Con State Lic:
886104
Engineer:
Address:
2012 ALTON PARKWAY #B
Lic Expire:
12/31/2020
Address:
Grading Permit Fee:
IRVINE CA 92606
Bus Lic:
BT30026827
Energy Compliance:
Phone:
650.638.1028
Lic Exp Date:
02/28/2020
Phone:
Code Edit : 2016
Worker's Compensation Insurance
Type of Construction: VB
Carrier:
ZURICH AMERICAN INS
Occupancy Group: R3/U
Policy No:
EWS107458602
Added /New sq.ft. Bldg: 0
Expire:
10/31/2020
Added /New sq. ft. Garage: 0
Additional Fee :
$0.00
No of Stories: 2
Building Setbacks
Rear: I
No of Units : 1
Grading Bonds Fee:
Front: I
Bldg Height: 0
Left: I
Bldg Sprinklers:
Grading PC Consultant :
Right: I
INSPECTOR
State Lic
DE VERA ABELARDO
22701 RASHDALL AVE
CARSON CA 90745
888-765-2489X7526 State Lic:S-005185
Designer: TSAI JERMONE
Address: 2012 ALTON PARKWAY #B
IRVINE CA 92606
Phone:
Special Conditions
Construction Valuation: $10.000.00
Fire Department
$40.00
Fire Inspection:
$0.00
Building Permit Fee:
$232.00
Excise Tax:
$0.00
Planning Department -
Plan Check Fee: $201.84
Additional Fee :
$0.00
Plan check Fee:
Grading Bond:
Overtime Plan Ck:
$0.00
Grading Bonds Fee:
$0.00
Fair Share :
Investigation Fee:
$0.00
Grading PC Consultant :
$0.00
SJH Trans :
Record Management:
$16.00
Grading Permit Fee:
$0.00
In -lieu Housing Fee
Energy Compliance:
$0.00
Grading PC Fee:
$0.00
Public Works Department -
CA Seismic Safety:
$0.00
WO Insp. Fee:
$0.00
Park Dedication :
$0.00
Disabled Access :
$0.00 -
PAN Plan Check:
$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
Plumbing %:
$0.00
TOTALFEE:
PROCESSED BY:
ZONING APPROVAL:
GRADING APPROVAL:
Plan Check Fee
0 0
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e
• e
mee•e•
c o
common
0
0 00
0 o m
omme
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $523.21
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
0 0
o••eoo
0 0
ommoo
0
ommm•
mmm•••
o m m
m •
ooemmm
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Fire Department
$40.00
Fire Inspection:
$0.00
Fire Plan Rev
$0.00
Demolition Fee
.$0.00
Building Dept Adm
General Service
Refund Deposit
Grading Bond:
0 0
o•e•m•
e
• e
mee•e•
c o
common
0
0 00
0 o m
omme
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00 Fee Due at Permit Issuance : $523.21
PUBLIC WORKS APPROVAL:
PLAN CHECK BY:
APPROVAL TO ISSUE:
0 0
o••eoo
0 0
ommoo
0
ommm•
mmm•••
o m m
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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
he 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
lot 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,
3usiness 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
mprovements 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
mproved for the purpose of sale).
1, 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
Ipply 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:
3y 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 legally
;ell 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
3rofessions CoqEf, 1s*%vTilable 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 Date
9If.EA.&D CONTRACTOR'S DECLARATION
hereby affirm under penalty ofperjury that I am licensed under provisions of Chaet�r 9 ( ommencing withXSe.,'OOOO) ofDivis'on 3 of the Busines a dProfeg suede andmy license is in full force
vit.effbgt. Licensp Class (^ Lb License No GPY i_d4 / Z Contractor S naturePORKERS'COMPE,,••NSATION DECLARATION
WIRUIN84FAILURE*TASRCyREWORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TNALTIES AND CIVIL FINES UP TO E HUNDRED THOUSAND DOLLARS ($100,060), IN ADDITION TO THE
IOST OPCOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
Celeby' affirm under penalty of perjury one of the following declarations:
0,me
self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the
Policy No.
rance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation
._r 2.(.ti' .4:I Policy Number � �r'�J Cd l q 5 Expiration Date wl �/ / Ze
of Agent
,ertify-Ihkt, 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
if I should, become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature ofKpplicant/
'P�LARATION REGARDING CONSTRUCTION LENDING AGENCY
by 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
Ider's Name Lender's Address
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 offs -cit or �countytcf ente a ab 'dwffftied property for inspection purposes.
nature of Prooertv Owner .or Authorized -Anent Print Property Owner's or uth rized Agent's IBam-a
ACTION `-DAT— BY WITH CODE OF FEDE
REGULATIONS PA RTCOMPLIANCE
OF TIT E40 AND ACIMD RU ESL I FOR
PERMIT EXPIRED
PERMITCANCELLED
PERMITFINAL / UASBESTOS NOTIFICATION IS NOTAPPLICABLE TO
CERTIFICATEOF�I?��C,Q- PROPOSED DEMOLITION
OCCUPANCYISSUED SIGNATURE:
Civil Code).
laws of California, and
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