HomeMy WebLinkAboutXR2022-2767 - PermitsCity of Newport Beach
O��EWPO,gT
Community Development Department- Building Division
1 DO Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone: (949) 644-3288
Inspection Requests Phone: (949) 644-3255
newponbeachca.gov/inspections
Combination Type - SFP ELEC
Work Class - Other
��1111111111111111111111111111111111111111111i 11COMB Permit : XR2022-2767
Plan Check No : PC2022-2609
Issued Date : 0110412023
Inspection Area :3
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION, BUT NO LATER THAN 3 YEARS FROM ORIGINAL ISSUANCE DATE
NO CONSTRUCTION RELATED NOISE ON SATURDAY OR SUNDAY IN HIGH DENSITY AREAS AND NO WORK ON SUNDAY AND HOLIDAYS IN ALL AREAS
Job Address : 518 ALISO AVE Legal Desc :
Description: SFR INSTALL 14KWH TESLA POWERWALL2 ENERGY STORAGE SYSTEM & DE -RATE MAIN SERVICE PANEL TO 175A
Owner: FOSS THOMAS L TR FOSS FAMILY TR
Address : 518 ALISO AVE
NEWPORT BEACH, CA 92663
Phone: (562)519-1871
Applicant:
SEMPER SOLARIS CONSTRUCTION
Address :
10713 NORWALK BLVD
SANTA FE SPRINGS, CA 90670
Phone:
(619)715-4054
Owner/Builder:
Address :
Phone
Code Edition : 2019
Type of Construction : V-B
Occupancy Groups: U,R-3
Bldg Height :
Building Setbacks
Flood Zone:
Use Zone:
PROCESSED BY: 4A,
SPECIAL CONDITIONS:
Contractor: SEMPER SOLARIS CONSTRUCTION
Address : 10713 NORWALK BLVD
SANTA FE SPRINGS, CA 90670
Phone:
(619)715-4054
Con State Lic
: 978152
Lic Expire :
10/31/2024
Bus Lic:
BT30075814
Bus Lic Expire : 07/31/2023
Workers' Compensation Insurance
Carrier: MIDWEST EMPLOYERS CASUALTY CO
Policy No: BNUWC0155108
W. C. Expire : 10/10/2023
Fire Sprinklers :
YES
Fire Hazard Zone :
NO
No of Units :
1
No of Stories :
2
Architect
Address
Phone: ...
State Lic
Engineer: WU HAROLD PING -HUNG
Address : 1168 N SAN GABRIEL RL, 61 E N
ROSEMEAD, CA 91770
Phone: (626)288-0708
Designer: SEMPER SOLARIS CONSTRUCTION
Address: 10713 NORWALK BLV[i
SANTA FE SPRINGS, CA 93370
Phone: (619)715-4054
Construction Valuation : $20,500.00
Added/New/TI sq. ft. Bldg : 0
Alteration sq. ft. Bldg :
Added/New sq. ft. Garage: 0
TOTAL sq. ft. : 0
i=:' ECI iICAL V9ETALLIC TUBING
(LM i IS NOT ALLOWED FOR
E:TE110;z APPLICATIONS
OWNER -BUILDER DECLARATION
I hereby affirm under penally 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
m 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
Imfessions 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 penny of
of more than five hundred dollars ($500).
3 1, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements are not intended or offered for sale. It, 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
nproved 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
ply t0 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),
I am exempt from licensure under the Contractors' Stale License Law for the following reason:
ly my signature below I acknowledge that, except for my person at 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
all a structure that 1 have built as an owner -builder if it has not boon Constructed in its entirety by Iicon sad contractors. I understand that a copy of the applicable law, Section 7044 of the Business and
'rofessions Code, is available upon request when this application is submitted or at the following Web site: hftp:h`www.leginfo.ca.govicalaw.him I.
Ilgnature of Property Owner or Authorized Agent Date
ACENSED CONTRACTOR'S DECLARATION r'
hereby affirm under penalty of perjury that i am licensed under provisions of Chapter 9 (commencing with Section o Divi 'on 3 of the Business and ree$$tor de, and Tolicense is In full force
nd effect. License Class License No Date 0 23 Contractor Signature
VORKERS' COMPENSATION DECLARATION
I: RNING: rAILURE TO SECURE WORKERS' COMPENSATION COVERAGES UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVILFINES UP TOONE HUNDRED THOUSAND DOLLARS ($i00,000), IN AUDITION TO THE
LSr O,' JoMPENSAT.ON, DA,AAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
erf�I h '�e and will maintain a certificate of consent to self4risure for workers' compensation.. Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th
Ance of the wunn for which this permit is Issued. Policy No.
he r� and will maintain 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' compensatioi
mirce carrier one policy number are
'i^r Policy Number Expiration Date
10 0' Agent Phone.#
certify that, In the, pei ,ormance of he 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 Califomia, and agre
' : Aould become subject to/tIr rkers' co tpensallon provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. (�, I
lalure of APPI'cant ` D�Ie�O�� L, ` 2
!retry, 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).
irises 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 applicablecity and county ordinances and state laws relating to building construction.
I authorize representatives of this city or county to enter tVAbove-tdentiff9d property for inspection purposes. _ Uj
ACTION DATE BY "'. DECLARATION OF COMPLIANCE WITH CODE Or FEDERAL FOR OFFICE USE ONLY
RFGULATIONS PART 61 OF TITLE 40 AND AQNID RULE
1403
PERMIT EXPIRED I ( LJ I SUBMITTED ASBESTOS NOTIFICATION TO
PERMIT EXTENDED _ QMD
PERMIT fiINA1 - rj -'L3 NOTIFICATION IS NOl'APPLICABLE TO
CERTIFICATE OF PROPOSED�ny��+I'O��I ���TTT���ppON
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