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Home My WebLink AboutX2021-2868 - Permits,,�,•„� City of Newport Beach - Building Division *X2021-2868* COMB Permit: X2021-2868 6 �. 100 Civic Center Drive, Newport Beach, CA 92660 Project No : 2501-2021 .r, �. Permit Counter Phone (949)644-3288 u. Inspection Requests Phone (949)644-3255 �a xrris�. 'x Combination Type - BLDG ELEC Issued Date : 02/17/2022 Inspection Area : 6 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 02/17/2025 OR PERMIT WILL BE INVAI-13 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: 4GIVERNY NB °. ®OB00; Description: SFR ENERGY STORAGE SYS (1) 13.5 KWH TESLA POWERBALL, (2) AC BATTERY SYS (5) KW 200 TESLA GATEWAY(2) INT BOARD(1) 125A BACKUP PANEL($) 3�OA°AC DISC Legal Desc.: Owner: NGUYEN MARK Contractor: SWELL CONTRACTORS Architect: 8'?'>��x'h"" Address: 4 GIVERNY Address: 1515 7TH ST #49 Address: & 1� ' NEWPORT BEACH CA 92657 SANTA MONICA CA 90401 '�° �a Phone: 714/913-8819 Phone: 310-340-0493 Phone: State Lic: Applicant: MEDINA BEN Con State Lic: 1021183 Engineer: ®° ° Address: 31225 LA BAYA DR Lic Expire: 11/30/2022 Address: WESTLAKE VILLAGE CA 91362 Bus Lic: 6T30072279 Phone: 818/735-7876 Lic Exp Date: 06/30/2022 Phone: State Lic: ° a °s° Code Edit : 2019 Workers Compensation Insurance Designer: WOOLEY SWELL Type of Construction: Carrier: SECURITY NATIONAL Address: 1515 7TH ST#49 Occupancy Group: U Policy No: SWC1354488 SANTA MONICA, CA 90401 Added /New sq.ft. Bldg: 0 Expire: 09110/2022 Phone: 310-340-0493 Added /New sq. ft. Garage: 0 No of Stories: 0 Building Setbacks Rear: / Special Conditions: No of Units : 0 Front: / Bldg Height: 0 Left: / Bldg Sprinklers: Right: / Flood Zone: Use Zone: Parking Spaces: 0 Fire Hazard Zone : N Construction Valuation: $17,000.00 Building Permit Fee: $365.00 Excise Tax: $0.00 Planning Department - Fire Department Plan Check Fee: $317.55 Additional Fee : $0.00 Plan check Fee : $52.00 Fire Inspection: $0.00 Overtime Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share : $0.00 Fire Plan Rev $48.50 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 PAN Plan Check: $0.00 Grading Bond: $0.00 Hazardous Mat $0.00 Electrical %: $47.78 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: $831.83 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Plan Check Fee : $0.00 Fee Due at Permit Issuance : $831.83 PUBLIC WORKS APPROVAL: PLAN CHECK BY: �- 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 checkmark(s) I have placed next to the applicable item(s) ction 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 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 fessions 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 more than five hundred dollars ($500). I, as owner oftjtgproperty, or my employees with wages as their sole compensation, will do (_) all of or L_) portions of the work, and the structure is not intended or offered for sale (Section 7044, iness and Pt ofe ssions 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 f9 vetnents are no{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 roved for the f urp6:e of sale). I, es 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 It io an ownerEf 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 exemp0ion;:censure under the Contractors' State License Law for the following reason: vy signature belovtl 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 legal a structur6Vh2t lheve 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 fessions Cede, is available upon request when this application is submitted or at the following Web site:http://w .leginfo.ca.gov/calaw.htmi. iature of Property Owner or Authorized Agent Date �-VSED CQNTftACTOR'S DECLARATION j reby affirmu rider penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7,(i00)IDf ��yQo o h Business and Profs s' ns Co my lid Inse9S�full force 'Effect. License Class License No Dat (/ /� ontractor Sionature 146RKERS'-jOFAPENSATION DECLARATION r — NARNMG: 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 1$100,0001, IN ADDITION TO THE -OST OF COMPENSATION, DAMAGES AS PROVIDED FORM SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 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 )erformance of the work for which this permit is issued. Policy No. have 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' compensation su ce carrier and policy number are: barrier Policy Number Expiration Date Vame of Agent Phone # I certify that, in the performance of the work f hich this permit 1 all not employ any person in any manner so as to become subject to the workers' compensati law of California, and agre hat, if I should become subject to the wo compe rovisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. /J signature of Applicant Dat� ZZ DECLARATION REGA D C ON LENDING AGENCY hereby affirm under pen o edury that there 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 3y 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, a ter the ove-identife y for inspection purposes. 3ignature of Property Owner or Authorized Agent Print Property Owner's or Authorized Agent's NameJy,&4154t,XebCdDate ACTION DATE BY F COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE PERMIT EXPIRED I SUBMITTED ASBESTOS NOTIFIC PERMITCANCELLED EPA PERMIT EXTENDED AQMD PERMITFINAL CERTIFICATE OF OCCUPANCYISSUED `2�'ZZ q/ �J BESTOS NOTIFICATION IS NOT ZROPOSEDD O TION SIGNATURE: