The URL can be used to link to this page

Home My WebLink AboutX2018-0791 - Permitsr� City of Newport Beach - Building Division 100 Civic Center Drive, Newport Beach, CA 92660 IIIIIIIIIIIIIIIII�IIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII COMB Permit: X2018-0791 Permit Counter Phone (949)644-3288 Project No: 0428-2076 Inspection Requests Phone (949)644-3255 Combination Type - MFP PLUM Issued Date : 03/21/2018 Inspection Area : 5 PERMITS EXPIRE 9$0 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m, to 6:30 - p.m. and Saturday from 6:00 a.m. to 6:00 p.m. No work on Sundays Job Address: 616 JASMINE AVE NB St: 1 FI: B or Holidays Description: MFR - MASTER. BATHROOM REMODEL (12015.3713) -REPLACE EXPIRED X2016-0634** Legal Desc.: P M 19446 PAR 1 UNIT 4 OF PROJECT LOCATED ON AP 459-066-21 TOGETHER Owner: MITCHELL TOBY# Contractor: EXTREME CLEAN CONSTRUCTION INC ®e°A Address: 618 JASMINE AVE, STE B Architect:TOR Address: 1390 TITAN WAY CORONA DEL MAR, CA 92625 Address:i" CA 92 825 Phone: 714-487-7722 Phone: BREA BREA CA 92 11 Phone: Applicant: EXTREME CLEAN CONSTRUCTION INC Con State Lic: 872678 State Lic: Address: 1390 TITAN WAY Lic Expire: 02/28/2020 Engineer: BREA CA 92825 Address: Phone: Bus Lic: BT30062591 714449-9011° s ° Lic Exp Date: 03131/2019.... Phone: State Lic: Code Edit: 2013 Worker's Compensation Insurance• Type of Construction: VB Designer: • ° GOGo•c ° ° G °°. .. Carrier: CALIF INS CO Occupancy Group: R3/UAddress: Policy No: 460565480115 Added /New sq.ft. Bldg: 0 0 0 Expire: 03/01/2019° Added /New sq. ft. Garage: 0 - Phone: No of Stories: 2° Building Setbacks Rear: / Special Conditions: of Units 2 : G • ° . . o G G • • • m • ° • G Bl Front: / Bldg Height: 0 ® o Bldg Sprinklers: Left:. I Flood Zone: Right: / Use Zone: Parkin Spaces: 0 Valuation: $0.00 Fire Hazard Zone : N ° 00004" g Permit Fee: $0.00 Excise Tax: heck Fee: $0.00 $0.00 Planning Department - Additional Fee: Fire Department 9 ° • GOfO ° $1$0.00 Plan check Fee: $0.00 me Plan Ck: $0.00 Grading Bonds Fee: $0.00 Fair Share Fire Inspection: $0.00 igation Fee: $0.00 Grading PC Consultant : $0.00 $0.00 [Buildingruction d Management : $0.00 SJH Trans : $0.00 Fire Plan Rev Demolition Fee $0.00 Compliance: $0.00 Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Grading Fee: $0.00 Building Dept Adm $0.00 Public Works Department- ismic Safety, : $0.00 WQ Insp. Fee: $0.00 . F General Service $0.00 ed Access : $0.110 Park Dedication : $0.00 Refund Deposit $0.00 P/W Plan Check: $0.00 ous Mat $0.00 Electrical %: $0.00 Grading Bond: $0.00 San Dist: g Green Fee : $0.00 chanical %: $0.00 $0.00 NMUSD Fee: $0.00 PI bing %: $0.00 $0.00 $0.00 TOTAL FE : $157.00 Plan Check Fee: $0.00 Fee a it Issuance $157.00 PROCESSED BY: - PUBLIC WORKS A PROVAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE: OWNER -BUILDER DECLARATIONthe I hereby affirm under penalty of Perlu ns Code: An xc ty orrcounty that requires a peemit to const uot,ralterf improve, indicated demol demolish, oroepair any structure, Prior oVtissuance; lso requires the applicant for 'Section 7031.5, Business and Profess Yrs' State usiness and ofessiolnsoCode)so9 that hetor shel is exempt from licensu ed nd the basis fo P helallegedfexe ptioln License (Chapter ng ith Section 0) of n 3 of he Any v olat ontof Secon 7031 5 p by any pl cant orva permit subjects he apple ant tota cry I penalty of not more than five hundred dollars ($500). ❑ I, as owner of the properly, or my employees with wages as their sole compensation, will do (_) all of or (_) portions of the work, and the structure is not intendedoffered for sale (Section provided v tl d that the 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,,p o improvements are not intended or offered for sale. If, however, fhe 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). rs to construct the project appl1, as owner of the roperty, amy to an owner of Property who exc usively contracting the with licensed who contracts for the projects with a licensed cContractor pursuant to he Contractors' State License rLaw). State License Law does no uilds or ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By a structure below at l have built as acknowledge that, except for f it has personal ot been constructed nll sidence in l Ilse entirety by licensed t have resided aontractorsr at least ol understane year lnd that a copy of theapplicable law, improvements 70-builder44tof the Bushis �lness and I cannot Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Date Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section7000)of Divu iI 3 f tCo tractor Signa Prat\ssi� code, a. nSl'my licens 's in u ora and effect. License•Gluss License No l� RKE)M COWENSATION DECLARATION i =EMPLOYER TO HE wl�R NUP RAILURE f0 $E4L�E AS WORKERS' COMPSNSATION FOR IN SECTION GE ISUNLAWFUL, AND F THE LABOR CODE, LL SUBJECT Al ATTORNEY'S FEES. RIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (E700,000i, IN ADDITION TO T COST OF CSMPENS T� I'L I I1d%by°RSfrrn undeE penalty of perjury one of the following declarations: have and hilt mafrlr��aln 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 P ante of the.work#or which this permit is issued. Policy No. .. C and wilj jnyyllain 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' compensatlo Ind 1gie-carrier and policy number are: Expiration Date Policy Number phone # n& of Agent rt;-,-,., ° Rcertiry that, in theperformance of the work for which this permit is issued, I shall not employ any person in any manner so as comply become subjectpriso the workers' compensation of California, and agree � of if? that, ba �om subject to the o e ' compensa' -provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions Date JJ 2� nature of Applicant CLARATION RE RIDING CONSTRUCTION LENDING AGENCY leby affirm unde penalty of perjury that there is a construction lending agency forthe pes Addaress of the work for which this permit is issued (Section 3097, Civll code). Ider's Name 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 I s -relating to building construction. l �� y / I authorize representatives of this city or county to ente9tr ab Ified property for insper loon arty owner's or Authorized Agent's Nam 'Ttj/ Date or Autnonzea Agent DATE BY REGULATIONS PART61 OIAN LE 40 AND MD RULE AL FOR OFFICE USE ONLY PERMIT EXTENDED' PERMIT FINAL / �l•L�i (�y�—. RESTOS NOTIFIC TION ISN LICABLE TO CERTIFICATE OF IP �pw� PROPOSED DEMOL N OCCUPANCY ISSUED %%-L- SIGNATURE: