No preview available
HomeMy WebLinkAboutUntitled City of Arcadia, CA Permit Na Elec-19-1643 + Development Services Department ' D Permit Type:Electrical / 240 West Huntington Drive,Post Office Box 60021 © '{ (— ' e l Arcadia,CA 91066-6021 ( 'Mork Classification:Electrical'Residential I I (626)574-5416 -- - Permit Status;Issued ARCADIA Issueoate:08/20/20191 Expiration: 02/16/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 11016 W Huntington DR B Arcadia,CA 5783007085 Contacts CYRUS LAM Owner TESTA ENERGY* Contractor 1016 W HUNTINGTON DR 3055 Clearview Way,San Mateo,CA 94402 (323)240-3174 888104 Description:2 ENERGY STORAGE SYSTEM, 125 AMP LOAD Valuation: $ 0.00 Tenant CENTER,amended 8/26/19 Total Sq Feet:' 0.00 Plan Check ft Plan fl • Fees Amount Payments Amount Paid Battery Storage Device 553.00 Total Fees $154.01 Battery Storage Device $53.00 Cash/Receipt ff REC-02192-19-- $101.01 Electrical Permit Issuance Fee $47.01 Cash/Receipt ff REC-02267-19 $53.00 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: •.• $154.01 r C�kt_ q./r .,9 �-- COMPLETED CALLS FOR INSPECTIONS Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection Item is needed. This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal.This permit expires and becomes null and • void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. • August 20,2019 Issued By: • Date August 26,2019 Page 1 of 1 • AR Cli el . 1 PERMIT/PLAN REVIEW APPLICATION ij S Development Services Department, 240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia ICENSED CONTRACTOR'S DECLARATION • WORKERS'COMPENSATION DECLARATION 'I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Lhapter 9(commencing with Section 7000,of Division 3 of the Business and rofessions Code,and my license is in full force and effect. I have and will maintain a certificate of consent to self-insure for workers' cense Class G/ 0 License No.e!• 0 .,, Date 12/-31"YJ compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. gnature of Contractor OWNER-BUILDE'__%' ARATION ❑ I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, i'Cartier demolish,or repair any structure,prior to its issuance,also required the applicant . policy Number for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section s section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is ,.,.,,� exempt there from and the basis for the alleged exemption. Any violation of Ul f f certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil -not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): !I. compensation Laws of California,and agree that if I should become subject to the I-t:workers'compensation provisions of Section 3700 of the Labor Code,I shall o L as owner of the property, or my employees with wages as their sole f.'f forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for )1 / _ sale(Section 7044,Business and Professions Code:The Contractors License da', Date '2. 2-y/h Signature — Law does not apply to an owner of property who builds or improves thereon, , or who does such work himself or herself or through his or her own c employees,provided that such improvements ate not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of S and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees, ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). 0 I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name • Date Signature - Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. C91 riame 6t-i$j,,/ 4- ` ,v Title 7I s✓vy..,,r VR NAME certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and e Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-men - u perry for inspection purposes. Signature - Date ��2-4 /7 ki City f ^ y 240 West ent Sed[on Dr1Ave,Post Office Box 60021 131 cs l 1f4rk PermitNo EIeC19 1643 rf Development Services De ' Il`+ - �' _ " Clpssr canon:Electrical Resldenal Arcadia,CA 91066-6021 �� t.,Va Lf � fi �"' (626)574-5416 `--: Permit Status:Issued ARCADIA Issue Date:'o8/20/2019 Expiration: 02/16/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number Ir 1016 W Huntington DR B Arcadia,CA 5783007085 Contacts 11 CYRUS LAM Owner TESLA ENERGY' Contractor 1016 W HUNTINGTON DR 3055 Clearview Way,San Mateo,CA 94402 (323)240-3174 888104 1, Description:3 ENERGY STORAGE SYSTEM, 125 AMP LOAD Valuation: $ 0.00 Tenant CENTER,amended 8/26/19 Total Sq Feet: 0.00 Plan Check tt Plan a Fees Amount Payments Amount Paid Battery Storage Device $53.00 Total Fees $154.01 Battery Storage Device $53.00 Cash/Receipt tt REC-02192-19 $101.01 Electrical Permit Issuance Fee $47.01 Cash/Receipt it REC-02267-19 $53.00 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $154.01 FPD Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. August 20, 2019 Issued By: Date August 28,2019 Page 1 of 1 . AR cfr,lio"vti �r ,.• PERMIT/PLAN REVIEW APPLICATION •.t4p, Development Services Department,240 West Huntington Drive,Post Office Box 60021 meo,n=rN Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION 0 I have and will maintain workers'compensation insurance,as required by Section 0 I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following mason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less) provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt them from and the basis for the alleged exemption. Any violation of 0 I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with hose provisions. compensation,will do the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Date Signature Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements am not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(I)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I ani exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. Name Title PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature Date 40-41)%1City of Arcadia, CA ,, Permit NO. Elec-19-1643 .\111,�! Development Services Department �1 v"'✓\T"^lS '- Permit Type::Electrical " 240 West Huntington Drive,Past Office Box 60021 L � 11111 '} {� �— ���.......c- ,...--- ` U Work,Classfhcatipn:Electrical Residential Arcadia,CA 91066-6021 `..3 (626)574-5416 - Permit Status:issued ARCADIA Issue'Date:08/2O/20191 Expiration: 02/16/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number ` ,1016 W Huntington DR B Arcadia, CA 5783007085 Contacts CYRUS LAM Owner TESLA ENERGY* Contractor 1016 W HUNTINGTON DR 3055 Clearview Way,San Mateo,CA 94402 (323)240-3174 888104 Description:1 ENERGY STORAGE SYSTEM, 125 AMP LOAD Valuation: $ 0.00 Tenant CENTER Total Sq Feet: 0.00 Plan Check N Plan N Fees Amount Payments Amount Paid Battery Storage Device $53.00 Total Fees $101.01 Electrical Permit Issuance Fee $47.01 Cash/Receipt N REC-02192-19 $101.01 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $101.01 COMPLETED CALLS FOR INSPECTIONS Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. • August 20, 2019 Issued By: Date August 20,2019 Page 1 of 1 4111113.0rOk1/4(4, i 1 PERMIT/PLAN REVIEW APPLICATION I3 j Development Services Department,240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full�7force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' I License Class (O License No. ' c$-} Exp. Date }C 3l compensation, as provided for by Section 3700 of the Labor Code, for the 1` Signature of Contractor r performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensationt� insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier `Z-0 (*Cr\ '\ yv' Ver-CSA Cst>-� demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number v—j Cv\$20\ for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for I Dare2-2c'1q Signature—__. sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(I)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attomey's fees. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT:APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for _1` further information. Dame C We•1kkl'\ �5I\ \0.r.'y Title 2S'`k PRINT NAME I certify that I have read this application and state that the above information is co t and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. signature G `—.-----7l�,. trate 2'-‘2 Cl—\Q Legend YOUR HOME Meter POWERED BY TESLA Distribution Panel TPowerwall and Equipment We are excited to design your home of the future and for you to join our mission to accelerate the worlds transition to sustainable energy. The day of your Installation,our team of two to three people will install your Powerwall.If you also have solar,an additional four installers could be on site. To ensure a quick and efficient installation,clear the ground,wall space,and any key access points. Extra space is great since we may use a small dolly to move Powerwall around. We look forward to getting started. m�� Front Of House L J Equipment installed in garage on south garage wall next to the Distribution Panel CONFIDENTIAL-THE INFORMATION HEREIN CONTAINED SHALL NOT SE USED FOR THE BENEFIT Energy Storage System 1016 W Huntington Dr,Apt.B.Arcadia,CA 91007 1 S L n OF ANYONET TESLA INC.,NOR SHALL IT BE INVS DISCLOSED IN WHOLE OR IN PART TO OTHERS Cyrus Lam OUTSIDE THE RECIPIENT'S ORGANIZATION,EXCEPT IN CONNECTION WITH THE SALE AND USE OF THE JB-9103040-00 Site Plan RESPECTIVE TESLA EQUIPMENT,WITHOUT THE WRITTEN PERMISSION OF TESLA INC. 8/14/2019