City of Yorba Linda 4845 Casa Loma Avenue Yorba Linda, CA 92886

Job Address: 3851 PRIMA BUCA

Building Department Permit Counter: 714-961-7120 Inspection Requests: 714-854-7411

Permit NO: YL-0070690 Residential Addition-Alteration Issued Date: 10/18/2021 Inspection Area:

Description of Work: INSTALLATION OF WALL MOUNTED DEDICATED 240 VOLT/ 60 AMP CIRCUIT FOR A TESLA EV CHARGING STATION.

City Standard Plan No:

Code Year: 2019 Occupany Group: TvnA of Construction:

Owner:

Phone:

Applicant:

Phone:

IN SONG 3851 PRIMA BUCA YORBA LINDA CA 92886

ALEX FERNANDEZ 17843 GLEN HOLLOW WAY RIVERSIDE CA 92504 909-952-0047

Contractor: TROUT ELECTRIC 17843 GLEN HOLLOW WAY RIVERSIDE CA 92504

Phone: 909-952-0047 Con State Lie No: 933396 Lie Exp Date:

Tenant: Type of Business: Contact Person: Tel No:

No. of Stories: No. of Units: Fuel Mod ID:

Architect:

Phone:

Engineer:

Phone:

Designer:

Phone:

FEES Construction Valuation:

Total Fee: $267.00

Special Conditions:

Building Permit (101]

Microfilm (101]

Other Building Fee (111)

Total Paid: $267.00

Wildl;md Urhan lntArface:

1111111111111111111111 11111 1111111111 111111111111111 II

201.00

2.00

64.00

Balance Due: $0.00

LICENSED CONTRACTOR'S DECLARATION

I hereby affirm that I am licensed under provisions of Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code, and my license is in full force and effect.

WORKER'S COMPENSATION DECLARATION

Contractor: I ROD I ELEC I RIC

I hereby affirm that I have a certificate of consent to self-insure, or a certificate of workers' compensation insurance, or a certified copy thereof. My workers' compensation insurance carrier and policy is:

License No: W/C Ins Carrier: 140MU1%R:O IN~UAANeE

933396 C10 Policy No: ~, R"W""C,.2"'8"'2"'i.,,.3'"i ____________ _

License Class: Exp Date: 01/28/2022

Lie Exp Date: 05/31/2022

Bus Lie No:

OWNER-BUILDER DECLARATION CERTIFICATE OF EXEMPTION FROM

WORKERS' COMPENSATION INSURANCE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: (check one) (This section need not be completed if the permit is for $500 or less)

__ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale.

I certify that in the performance 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.

__ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project.

Applicant's Signature _________ Date: ___ _

__ I am exempt under Sec. __ , B&PC for this reason

NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code you must forthwith comply with such provisions or this permit shall be deemed revoked.

CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. CJ. Lenders Name:

Will the proposed building or modified facility be within 1000 feet of the outer boundary of a school? I have read the Hazardous Material Information Guide and the SCAQMD Permitting Checklist. I understand my requirements under the State of California Health & Safety Code, Section 25505, 25533 & 26534 concerning hazardous materials reporting.

Will the applicant or future buildng occupant handle a hazardous material or a mixture containing a hazardous material equal to or greater than amounts specified on the Hazardous Materials Information Guide? Will the intended use of the building by the applicant or future building occupancy require a permit for construction or modification from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for

Yes

Yes

Yes

I CERTIFY THA Tl HAVE READTHIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRESENTATIVES OF THIS CITY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PURPOSES.

No

No

No

I UNDERSTAND THAT SHOULD WORK BE SUSPENDED FOR 180 DAYS OR MORE THIS PERMIT SHALL BE CONSIDERED EXPIRED BASED ON THE 2019 CALIFORNIA BUILDING CODE.

D The IN SONG/ALEX FERNANDEZ has/have notified the Homeowners' Association regarding the proposal, and the compliance with the Convenants, Conditions, and Restrictions (CC&Rs) applicable to the property.

D The property is not subject to Convenants, Conditions, and Restrictions (CC&Rs) nor Is approval by a Homeowners'

Signature of Applicant/Agent: ___________________ Date:

Print Applicant/Agent's Name:. ___________________ Phone: _____ _

proposal is in

Association.

INSPECTIONS INSPECTOR/DATE INSPECTIONS INSPECTOR/DATE Issued By:----Building Final Plumbing Final Electrical Final Mechanical Final

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c1+lflQZQ~? o ~ l,LDING DIVISION

"REVIEWED FOR CODE COMPLIANCE" THIS SET OF PLANS AHO SPECIFICATIONS II.UST BE KEPT ON THE JOB AT ALL TIMES A!IO IT IS UIILAWr\JL TO IIAKE CHANGES OR ALTERATIOHG WITHO~ T WRI • PERillSSION FROil THE BUILDING Dl~ SI BY: t DATE: =--~~(

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10 '7 /

)n1all ~p;,l ia nc o.: b,anch 1. ir,uits {2. mi11) Laundry Circuit lS (lnVI\ Y.

1500 V,\ ): 2 Circuit, J Ci~cuit(s)

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/I.PPLII\NCE5 ,'\NO E'.:!ll ll'l,1H-IT-Va. l~ r., are mirtimum s,use .:ictual v;;l11cs ii known tn h~ f) r~atc r. tr1tr1 N//\ tf noi rr:.sent ~ t o r 0_1 rct ~•le

, ... ~icr owave Cc mp acto r Dish\', a~h~r fk;,osal

Proposed EVS: circuit Pool/~pa Pumi; l horsepower

Pool/~p. Pump 1.5 horsepowe r Pool/S;ia Pump 2 hcrsepov,cr Oven R;inee Electric W2ter r.ea, cr FAU.

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7?.CO Us:.)_Q 192D ~,·oo --;;----2SCO Jjy,.:;, ,. coo •;-tc, SJ.OJ 450:J ___ _

15CC~'?'o00

Subtota l {A) '-{QC; 7 f Subto.;d (A.) minus 10,000 VA J 07 7 / X 0.40= )J..,? W,4

clu\ in.coo

To:.:i l I\ ,_ u:i , ~, " • - ' / .. L O '"" n•rnpobtc r:i \i nc. or A/C circ11', breaker rau ng {C) ~l/ U

Tot.al c1 ,,m,md Is D/2/i0V= ! J /. ,~./ Arnp: D-={B) + {C ) J I C. J$,. . ,.,(

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L CITY OF Y•! LINDA BUILDIN 1l IJn'ISION ------------------~:-;,~'RtEEVVIEJEjWiEE:OD~F~Oi°RR:CCODE C0,\1PLIANCE•

THIS SET OF PLANS AHO SPECirlC:.Tlo~s WUST BE KEPT ON THE JOSAT AU TIMES ANO IT IS UN!.A\1/FUL TO IW(£ CHANGES OR ALTERATIONS w1rnou r WRJTTE~ PERIIIS~ FROII THE BUILDING DMSION. BY: ________ _

DATE: ----

I r PRODUCT OVERVIEW

Y pa number 1457768··• -· . This manual applies to Wall Connectors identified b rt

product Specifications . - - - - -

Voltage and Wiring

current Output Range

Terminal Blocks

Supported Conduit Sizing ,- - · ·- - - -

Grounding Scheme

Frequency

Cable Length

Wall Connector Dimensions

Wire Box Bracket Dimensions

- - --- - -- - --Weight ( including wirebox)

Operating Temperature

Storage Temperature

Enclosure Rating

Ventilation

Means of Disconnect

Ground Faul t Circuit Interrupter

Wi-Fi

Agency Approvals

Nominal 200-240 V AC sing le-phase

12 - 48 amps

12-4 AWG (3.5 - 25 mm2) , copper only

W' (21 mm) default, 1" (27 mm) opt iona l - . -· TN/ TT

50/ 60 Hz

8.5' (2 6 m) or 18' (5.5 m)

Height 13.6" (345 mm)

Width: 6.1" (155 mm)

Depth: 4.3" (110 mm)

·• - - - - - -· -

Height: 9.8" (250 mm)

Wi dth: 4.7" (1 20 mm)

Depth: 2.0" (50 mm)

10 lb. (4.5 kg) -22 ' F to 122' F (-30°C to 50°C)

-40°F to 185 ' F (-40 °C to 85 ' C)

Type 3R

Not required

External branch circuit breaker

Integrated, no addit ional required (CC\D20)

2.4 GHz, 802.11b/ g/ n

cULus - E351001

Transportation and storage: Ensure that Wall Connector is within storage temperature when moving,

transporting, or storing. . . _ _ . . . CITY OF YORBA .LINDA This device complies with part 15 of the FCC Rules. Operat ion 1s sub1ect to ~ 112.~'«I~ f,P~~~p(lNO) This device may not cause harmful interference, and (2) this device mu~ a~~f1YR1Q~ .'if:e~t % -El.tANCE• received. including interference that may cause undesi red operation .THIS SET OF PLANS AND SPi:CIFICAl iONS MUST BE KEPT ON

4

THE JOB ~1 ALL TIMES A,~D IT:, UNLAWFUL TO fiAKECHAIIG•S OR ALTE~TIONS ¥/iTl~Ql: i WRllTEH PER!!ISSION FROII THE BUILDING DMSIOti. BY: DATE: _ ____ _

Gen 3 Wall Connector Manual

I

I PRODUCT OVERVIEW T / Circuit Breaker Rating / Maximum Output

Power Output

IC

For maximum power output, install a standard double pole 60 amp circuit breaker. Wall Connector includes integrated GFCI protection - do not install a GFCI circuit breaker.

Wall Connector incorporates automatic load management. which allows the max output to be customized to an existing power supply. If the electrical supply is unable to support the 60 amp configuration, select a lower amperage configuration.

Circuit breaker· (amps) Max output (amps) Power output at 240 volts (kW)

60 48 11.5

so 40 9.6

7.6 40 32

5.7 30 24

3.8 20 16

2.8 15 12

- - - - -- - --NOTE: External disconnect switches are neither required nor recommended. NOTE: Circuit breaker size is programmed during tr,e commissioning process. See Commissioning

Procedure on page 22 for details. NOTE: some Tesla vehicles may draw less current than the max output. Actual charging rate depends on Wall Connector output and onboard charger in the vehicle.

Branch Circuit Conductors and Ground Wire • If installing for less than maximum power, refer to local electrical code to select correct conductors and

ground wire size that are suitable for the chosen circuit breaker. , If installing for maximum power, use minimum 6 AWG, 90° C-rated copper wire for conductors.

NOTE: Upsize conductors if necessary. , For sites with multiple Wall Connectors, each Wall Connector must have its own branch circuit with L 1.

L2/N, and Ground. • COPPER WIRE TERMINATIONS ONLY for landing in Wall Connector wirebox terminals. Conductors can

be stranded or solid. • For outdoor installations. use watertight fittings when securing feeder wires to the wirebox.

Grounding Connections CITY 0 F YORBfi LI NDA Wall Connector must have a ground path back to the main equiP.~~i~i k RiW~(pcfirit\ on~s@~ithout a proper ~round connection, the Wall Connect_or ~ill fault duriniai/U~f'ilrl~~[ s-Wfan~~ t 'est',18q.eiiws-ent-ground~ng cond_uctor must ~e run with the c1rcu1t conductors ~ E\dl'O(l)m_li)~~J~~~~~

1~~+g\lf\~J1t:;,roN grounding terminal in the w1rebox. Install a ground (PE) wire ~V.~ciEeiJ'~~<iBn111utrcwlq~\;i~ 1-'p~ H~ ifu. 'Wn.1l1NG DMSION. • . ~ ll'l"AOTflHE

BY: DATE~:::::::::::::::::::

Gen 3 Wall Connector Manual

-:s:;;;;~ •

Job Address:

City of Yorba Linda 4845 Casa Loma Avenue Yorba Linda, CA 92886

3851 PRIMA BUCA

Building Department Pennit Counter: 714-961-7120 Inspection Requests: 714-854-7411

Permit NO: YL-0070690 Residential Addition-Alteration Issued Date: 10118/2021 Inspection Area :

Description of Werle STATION.

INSTALLATION OF WALL MOUNTED DEDICATED 240 VOLT/ 60 AMP CIRCUIT FOR A TESLA EV CHARGING

Owner: IN SONG Code Year: 2019 Contractor: TROUT ELECTRIC Occupany Group:

Type of Conslruction:

CALL FOR INSPECTION BY 3:30PM THE DAY PRIOR TO THE DESIRED INSPECTION DATE. INSPECTIONS REQUESTED ARE NOT GUARANTEED TO BE PERFORMED THE NEXT DAY DUE TO THE CURRENT INSPECTION WORK LOAD. INSPECTIONS WILL BE SCHEDULED ON THE NEXT AVAILABLE BUSINESS DAY.

I UNDERSTAND THAT SHOULD WORK BE SUSPENDED FOR 180 DAYS OR MORE THIS PERMIT SHALL BE CONSIDERED EXPIRED BASED ON THE 2019 CALIFORNIA BUILDING CODE

--T~yp~e_o_f_l_ns __ p_e_ct_io_n _ _._! C_od_e_.l __ D_a_te _ __. ____ ln_s..:.p_ec_t_or ___ ..,11 Type of Inspection I Code I Date Inspector

ELECTRICAL

TAmnPnwAr 300

Grnundlna Bonc1ino 302

Meter PedAstRI 303

Underaround PVC Metal 305

Conduit 306

Rouoh Wirina Recentacle S 310

SP.rvir:e Power 313

Smoke CO Detectors 320

EIActrir.RI Final 390

EIP.ctric Commmv RP.IP.a!=if! 399

*OCFA INSPECTION "All other OCFA lnspectlons are recorded on the OCFA Inspection

Record Card. Fire Sprinkler/Rough Hydro I I OCFA Project Final I I

WHEN ALL "FINAL" INSPECTIONS ARE SIGNED, THIS CARD BECOMES A "CERTIFICATE OF OCCUPANCY" FOR GROUP WHEN ALL "FINAL" INSPECTIONS ARE SIGNED FOR COMMERCIAL THIS CARD BECOMES A "TEMPORARY CERTIFICATE OF OCCUPANCY" UNTIL THE FORMAL, SEPARATE "CERTIFICATE OF OCCUPANCY" HAS BEEN ISSUED FOR THIS PROJECT.

City of Yorba Linda, CA FINANCE DEPARTMENT 4845 Casa Loma Ave

Y_9Pla ~1nda, CA 92886-3364 / (714) 961-7100

Welcome

000479-0013 CityHall 10/18/2021 10:55AM

MISCELLANEOUS BUILDING PERMIT (101) 2022 Item: 101 1@ 203.00

BUILDING PERMIT (101) 203.00 Payment Id: 33571

---------------

Subtotal Total

CHECK Check Number 50876

Change due

Paid by: IE INC TROUT ELECTRIC

Comments: YL 70690 IE INC TROUT ELECTRIC

Thank you for your payment

CUSTOMER COPY

203.00

203.00 203.00

203.00

0.00

I

City of Yorba Linda 4845 Casa Loma Avenue

• Yorba Linda, CA 92886 714-961-7120

Number: 162734 Date: 10/18/2021

Submitted: 10/05/2021 Plan Check Expires: 04/03/2022

Building Receipt RECORD INFORMATION

Record ID: YL-0070690

Record Type: Residential Addition-Alteration

Application Name: EV CHARGER

Property Address: 3851 PRIMA BUCA 932-54-370

Description of Work: INSTALLATION OF WALL MOUNTED DEDICATED 240 VOLT /60 AMP CIRCUIT FOR A TESLA EV CHARGING STATION.

Applicant: ALEX FERNANDEZ TROUT ELECTRIC 17843 GLEN HOLLOW WAY RIVERSIDE, CA 92504

Professional: TROUT ELECTRIC 17843 GLEN HOLLOW WAY RIVERSIDE CA 92504

PAYMENT DETAIL

Date

10/18/2021

FEE DETAIL

Payment Method

Cashier

Fee Description

Building Permit (101) Microfilm (101)

Cashier Breakdown

(101) $203.00

Print Date: 10/18/2021

Technician

DCLARK

Invoice #

190599 190599

Owner: IN SONG 3851 PRIMA BUCA YORBA LINDA CA 92886

Contractor No: 933396

Comments

Fee Amount

$201 .00 $2.00

$203.00

Current Paid

$201 .00 $2.00

$203.00

Amount

$203.00

Valuation:

PA I D OCl 1 8 2021

Page 1