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Home My WebLink AboutF2022-0227 - Permitswane City of Newport Beach - Building Division *F2022-0227` .^ d� 100 Civic Center Drive, Newport Beach, CA 92660 ary 7: Permit Counter Phone (949)644-3288 ��LI84xU•�t� Job Address: 4250 BIRCH ST NB FIRE Permit: F2022-0227 Project No : 1116-2022 Inspection Requests Phone (949)644-3255 Description: COMM HOOD & DUCT SYSTEM "BENIHANA" X2021-2481 Inspector Area: FIRE Legal Description: P BK 45 PG 25 PAR 2 Owner: BENI INVESTMENTS LLC Contractor: V FIRE SYSTEMS CORP Address: 21500 BISCAYNE BLVD Address: P O BOX 13278 AVENTURA FL 33180 SAN BERNARDINO CA 92423 Phone: Phone: 909.947-5055 Applicant: V FIRE SYSTEMS CORP Con State Lic: 779913 Address: P O BOX 13278 Lic Expire: 06/3012022 SAN BERNARDINO CA 92423 Bus Lic: BT02031803 Phone: 909.947-5055 Lic Exp Date: 0212812023 Code Edit: 2019 Worker's Compensation Insurance Type of Construction: V-B-SPR Carrier: INS CO OF THE WEST Occupancy Group: B Policy No: WSD5033410 Added /New sq.ft. Bldg: 0 Expire: 04/01/2023 Added /New sq. ft. Garage: 0 No of Stories: 1 Issued Date: 04/2712022 No of Units : 0 Setback- Front: Flood Zone: Rear: Bldg Sprinklers: Y Left: Right: FEES Construction Valuation: $0.00 Building PC Fee: $0.00 Fire Residential Alarm PC Fee: Building Overtime PC Fee: $0.00 Planning Counter Review: Building Extention Fee: $0.00 Planning Zoning PC Fee: Building Investigation Fee : $0.00 Fire Plan Check Fee: $120.00 Public Works PC Fee Fire Permit Fee : $233.00 Public Works Traffic Plan Check Fee; Building Permit Fee : $0.00 Architect Address: Phone: Engineer: Address: Phone: Designer: Address: Phone: Special Conditions: $0.00 $0.00 $0.00 $0.00 $0.00 State Lic: State Lic: m VILLARREAL CHRIS T ° P.O. BOX 13278 .... SAN BERNARDINO CA 92423 •c ° a• 6 ° .s a a c• a® a Records Management : $4.00 $0.00 $0.00 TOTAL FEE : $357 0 Plan Check Fee: $0.00 Fee Due at Permit Issuance : $357.00 PROCESSED BY: OTHER DEPARTMENT: ZONING APPROVAL: n PLAN CHECKED BY:: FIRE APPROVAL: APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION • C®80a • eab•• osac•• i • Y 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) (Section 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 the 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 Professions 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 not 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 U portions of the work, and the structure is not intended or offered for sale (Section 7044, 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, provided that the improvements 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 improved 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 apply 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). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By 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 legall) sell 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 Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sectio 7000) of Division 3 of the Business 4HUNDRHOUSAND Code, an my license is in full force and effect. License Glass License No Date 2. 2 Contractor Signature11 6rRRKRS'COMf.ENSATION DECLARATION WARNING, FAILURE TO Sfeft WORKERS'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE DOLLARS I$100,Dp01, IN ADDITION TO THE COSYOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: ❑` I`4;t and wfft4ait§tain 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 Ipp ft ce of tale wtflrfor which this permit is issued. Policy No. ileve 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' compensatiol 3ar1G@ carrier and policy number are: 'Garner Policy Number Expiration Date tyinawraf.Anent •" Phone # _ bml; that, Ili*%d pgrformanc¢`pf the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the v1(Orkers' compensation laws of California, and . if I should become subiect t' t l e workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. of Applicant hereby affirm under`penalty okj erjury 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 y my signature below, I certify o 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 or antes and state laws relating to building construction. I authorize representatives of this city or county to ent r he above-iden ied properly for inspection purposes. innatllre of Pronertv Owner or Authorized Agent / �� Print Property Owner's or Authorized Agent's Name ACTION BA T€ BY DECLARATION OF COMPLIANCE YYITH CODE OF FOR OFACE USE ONLY FEDERAL REGULATIONSPART 69 OF TITLE40AND AQMD RULE 1401 - PERMITEXPIRED ❑ ISUBMITTEDASBESTOS NOTIFICATION TO: ❑ EPA ❑ AQMD PERMIT CANCELLED PERMiTEXTENDED 0 ASBESTOS NO DON IS NOT APPLICABLE TO PROPOSED DEMOLITION. PERA41TFINAL (,i CER77FICATEOF SIGNATURE. OCCUPANCYISSUED