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Home My WebLink AboutXR2023-0626 - Permitsa��WPoRT City of Newport Beach @ Community Development Department- Building Division F f 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone: (949) 644-3288 u 2 Inspection Requests Phone: (949) 644-3255 �gcicoaN�P newportbeachca.gov/inspections Combination Type - I ELEC Work Class - Other 11111111111111111111111111111111111111111111�m11111�IIJillCOMB Permit : XR2023-0626 Plan Check No : PC2023-0494 Issued Date : 04/12/2023 Inspection Area : 6 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 r Job Address : 4 FATHOM DR Legal Desc : N TR 8426 ELK LOT 2 Description: ATTACHED SF -ENERGY STORAGE SYSTEM; (2) TESLA POWERWALL, (1) 200A SUB-PNL, (2) AC DISCONNECTS Owner: W FILLMORE WOOD Address : 4 FATHOM DR CORONA DEL MAR, CA 92625 Phone Applicant: A P ELECTRICAL Address : 16238 RAYMER ST UNIT B VAN NUYS, CA 91406 Phone : (818) 483-8026 Owner/Builder : Address : Phone Contractor: A P ELECTRICAL Address : 16238 RAYMER ST UNIT B VAN NUYS, CA 91406 Phone : (818) 483-8026 Con State Lie : 974115 Lie Expire: 06/30/2024 Bus Lie: BT30061309 Bus Lie Expire : 11/30/2023 Workers' Compensation Insurance Carrier: STATE COMP Policy No: 9221712 W. C. Expire: 10/19/2023 Architect Address Phone: State Lie: Engineer: Address Phone : Designer: A P ELECTRICAL Address : 16238 RAYMER ST UNIT B VAN NUYS, CA 91406 Phone: (818)483-8026 Code Edition : 2022 Fire Sprinklers : NO Construction Valuation : $20,350;0& Type of Construction : V-B Fire Hazard Zone : NO Added/New/TI sq. ft. Bldg : 0 Occupancy Groups : U,R-2 No of Units : 3 Alteration sq. ft. Bldg : , 0 Bldg Height : No of Stories : 1 Added/New sq. ft. Garage : TOTAL sq. ft. 0 Building Setbacks : Front: 15, Rear: 15 Flood Zone : X Use Zone : PC - Jasmine Creek PROCESSED BY: Iliic SPECIAL CONDITIONS: OWNER -BUILDER I hereby affirm under penalty of perjury that I am exempt from the Contractors' Slate License Law for the reasons) indicated below by the checkmark(s) I have placed next to the applicable ftem(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, after, improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for the permit to file a signed statomant 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 licensors 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). El 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' Slate 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), 11 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 legall 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 Code, is available upon request when this application is submitted or at the following Web site:http:llw .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 7000) of Division 3 of the Business and ProressionrCooe, and my license is In full force and effect. License Class License. No Date S7-/2-2-3 Contractor Signature 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 3701 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. I hereby affirm under penalty of perjury one of the following declarations: 13 1 have anu will mdlntain 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 ,performance of the work for which this permit is issued. Policy No. IMI have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for whlch this permit is issued. My workers' compensatiol 1, SUr:.nce carrier and policy number are: (V'Car. ler_��'( Policy Number Expiration Date aZ of Agent Phone # i0i certify that, ;T theperformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject t0 the workers' compensation laws of California, and afire 1Itnal, If I shouia hecomR subject to rkers' ompensaticn provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. IlSionature of Applicant ._�_._ Dete.,4,:.. /-/2-a3 ;DCCUAATiON REC;,RRING CONSTRUCTION LENDING AGENCY 1II hereby affirm under T'anally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sectlon 3097, Civil Code). I,I.endnr s Name Lender's Address &y to, signatura 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 ants:tke-eb lfied property for inspection purposes. (� �q Si nature of Properly Owner. or Authorized Agent� PrintProoerty Owner's dr Autnorizatl Anent's Namw kvbd Mf'itlr n.,o 4y-/J-2 i ACTION I DATE I By PERMIT EXPIRED PERMIT CANCEL! PERMIT EXTENDI DECLARATION OF COMPLIANCE WITH CODE OF FEDEI REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE rtmmll pllyrL C� F� WASBESTOSNOTIFICATION IS NOTAPPLICAHLIF 70 CERTIFICATE OF 0 %3 y/1�-'K� PROPOSED DEMCLIT�.Ohi� OCCUPANCYISSUED SIGNATURE: yGS`� FOR OFFICE USE ONLY