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Home My WebLink AboutX2022-0189 - Permitswn City of Newport Beach - Building Division L+1i 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 v.-. Inspection Requests Phone (949)644-3255 Combination Type - BLDG ELEC *X2022-0189* COMB Permit: X2022-0189 Project No : 0180-2022 Issued Date : 02122/2022 Inspection Area : 3 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0212212025 OR PERMIT WILL BE INVALID 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: 1907 BERYL LN NB Description: SFR ENERGY STORAGE SYSTEMS Legal Desc.: N TR 1806 LOT 36 _ ff c®>� Owner: POLENZANI MICHAEL Contractor: TESLA ENERGY OPERATIONS Architect: - Address: 1907 BERYL LN Address: 2102 ALTON PARKWAY #B Address: NEWPORT BEACH, CA 92660 IRVINE CA 92606 Phone: Phone: 650-638-1028 Phone: State Lic: Applicant: ALLEN BRIDGET Con State Lic: 888104 Engineer: Address: 2102 ALTON PARKWAY STE B Lic Expire: 12/3112022 Address: IRVINE, CA 92606 Bus Lic: BT30026827 Phone: 714-450-2839 Lic Exp Date: 02128/2022 Phone: State Lic: Code Edit : 2019 Type of Construction: Occupancy Group: U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 0 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Construction Valuation: $16,000.00 Building Permit Fee: $348.00 Plan Check Fee: $302.76 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $749.31 PROCESSED BY: ZONING APPROVAL: GRADING APPROVAL: Worker's Compensation Insurance Carrier: ZURICH AMERICAN INS Policy No: EWS107458604 Expire: 10/31/2022 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: I 'arkina Spaces $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $45.55 $0.00 $0.00 Plan Check Fee Designer: Address: Phone: Special Conditions: Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check: $0.00 San Dist: $0.00 NMUSD Fee: $0.00 Fire Department $52.00 Fire Inspection: $0.00 Fire Plan Rev $0.00 Demolition Fee $0.00 Building Dept Adm General Service Refund Deposit Grading Bond: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $375.95 Fee Due at Permit Issuance : $373.36 PUBLIC WORKS APPROVAL: PLAN CHECK BY: APPROVAL TO ISSUE: m000c„c 0 o° o0 oo° o o , 00 0000 mommam a°pa mo • e 000°o ooamo° 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) action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, priorto its issuance, also requires the epplicant�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 of the property, or my employees with wages as their sole compensation, will do U all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, uness 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 Irovements 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 (roved 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 Law does not r1y 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). I am exempt from licensure under the Contractors' State License Law for the following reason: 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 legall7 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 fessions CBQa is available upon request when this application is submitted or at the following Web site:http://www. leginfo.ca.gov/calaw. html. natureof�Pro�]erty Owner or Authorized Agent Date :ENSED�CO�ITRACTOR'S DECLARATION ereby a((fm un per penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 000) of Division 3 of the Business an Profess ns Cod , and rrlylicense is in full force I effect. License Class License No na1�` [l)rrvLr,rar-.tnc� Fy-�/.� ALB TION DECLARATION IARNING: FAa-URF.TPSECURE 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 :OGT OF COMPEMSATON, DAMAGES As PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. pereby affims u ndq penalty of perjury one of the following declarations: 1 have anE 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 eTibrmance of the work for which this permit is issued. Policy No. have and.111l�rrl�intain 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' compensatiol su ce carriVandpoli�cy� number are: ....�yV, 9IVV(NI"Lu+ Policy Number 10-74S83—n Expiration Date IO1b(i2o2� :arrler lame of Agent Phone# `llK—�1,50-2� —7 1 certify that, in the pe ormance 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 agree iat, if I should become bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Iignature of Applicant �o,1--� AZ _. DateY Z1/ 2-2-1ZOZZ )ECLARATION REGARDING CONSTRUCTION LENDING AGENCY / 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) Ender's Name Lender's Address ly 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 cou toe er'the above-i ntiifed property for inspection purposes. \ / rt I p Iignature of Property Owner or Authorized Agent C;(,4 f�.'V-- Print Prooertv Owner's or Authorized AGent's Name X d h e 0IP-{-M ACTION PERMIT EXPIRED PERMIT CANCELLED PERMIT EXTENDED PERMIT FINAL CERTIFIC4TEOF OCCUPANCYISSUED DATE BY DECLARATION OF II REGULATIONS PA TOMPLIANCE WITH CODE OF 1 OF TITLE 40 AND QMD RULERAL FOR OFFICE USE ONLY I SUBMITTED ASBESTOS EPA TO IS NOTAPPLICABLE TO