HomeMy WebLinkAboutX2021-2481 - PermitsCity of Newport
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Beach - Building Division
II IIII I IIII II III IIII IIII�I I�I I II COMB Permit: X2021-2481
100 Civic Cents
Drive, Newport Beach, CA 92660
X 2 0 2 1 2 4 8 1 Project NO : 2144-2021
Permit Counter
hone (949)644-3288
Inspection Req
sts Phone (949)644-3255Issued
Date : 03I30/2022
Combination Type
- CIP ELEC MECH PLUM GRAD
Inspection Area : 7
PERMIT EXPIRES
180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY 0313012025 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: 4250 BIRCH ST NB
Description: COMM DINING ROO
ADDITION 615 SF "BENI HANA" & ADAIPARKING IMPROVEMENTS
Legal Desc.: P BK 45 PG 25 PAR 2
Owner: BENI INVESTMENTS ULC
Contractor: GRAVES CONSTRUCTION Architect: RILEY MICHAEL
Address: 21500 BISCAYNE BLVD
Address: 27162 BURBANK BLVD Address: 3190-K AIRPORT LOOP DR
AVENTURA, FL 33180
FOOTHILL RANCH CA 92610 COSTA MESA CA 92626
Phone: 817-922.1504
Phone: 949-467-1799
Phone: 909-618-8850 State Lic:C017848
Applicant: TANAKA RICHARD
Con State Lie: 10007B9
Engineer: NAGARAJAN SIVARAM
Address: 22855 SAVI RANCH P
WY #E Lie Expire: 11/3012022
Address: 167 MATISSE CIRCLE
YORBA LINDA, CA 921187
Bus Lie: BT30078367
ALISO VIEJO CA 92656
Phone: 714-474-6138
Lie Exp Date: 03/31/2023
Phone: 714-444-2422 State Lic:S-006349
Code Edit : 2019
Worker's Compensation Insurance
Designer:
Type of Construction: V-B-SPR
Carrier: EVEREST PREMIER
INS CO Address:
Occupancy Group: B
Policy No: 7600022590211
Added /New sq.ft. Bldg: 0
Expire: 08/0112022
Phone:
Added /New sq. ft. Garage: 0
No of Stories: 1
Building Setbacks Rear: /
Special Conditions: SAUSD FEES PAID
No of Units: 0
Front: /
OC HEALTH APPROVAL
Bldg Height: 0
Left: /
RECEI1469
Bldg Sprinklers: Y
Flood Zone: X
Right: /
Use Zone: Parking Spaces:
0 Fire Hazard Zone : N
Construction Valuation:
100.00
Building Permit Fee: $1,402.00
Excise Tax: $0.00
Planning Department - Fire Department
Plan Check Fee: $1,287.74
Additional Fee : $0.00
Plan check Fee : $52.00 Fire Inspection: $0.00
Overtime Plan Ck: $0.00
Grading Bonds Fee: $0.00
Fair Share: $9,645.66 Fire Plan Rev $48.50
Investigation Fee: $0.00
Grading PC Consultant: $137.76
SJH Trans : $3,683.85 Demolition Fee
Record Management: $122.00
Grading Permit Fee: $973.00
In -lieu Housing Fee: $0.00 Building Dept Adm $0.00
Energy Compliance: $86.10
Grading PC Fee: $876.75
Public Works Department - General Service $0.00
CA Seismic Safety: $34.44
WQ Insp. Fee: $0.00
Park Dedication: $0.00 Refund Deposit $0.00
Disabled Access : $123.00
PAN Plan Check : $406.00 Grading Bond: $0.00
Hazardous Mat $0.00
Electrical %: $367.04
San Dist: $3,051.63
Building Green Fee : $5.00
Mechanical %: $288.39
NMUSD Fee: $0.00 $0.00
Plumbing %: $235.96
$0.00
TOTAL FEE : 122,826.82
Plan Check Fee :
$22,826.82 Fee Due at Permit I suance : $0.00
PROCESSED BY:�'
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ZONING APPROVAL:
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PLAN CHECK BY:
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GRADING APPROVAL:
APPPOVAI n ISSUE:
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
is 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
'rofessions 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
of more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044,
lusiness 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
nprovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner-Buiider will have the burden of proving that it was not built or
nproved for the purpose of sale).
11, 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
pply 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). -
7 1 am exempt from licensure under the Contractors' State License Law for the following reason:
ly 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 legally
ell 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
'rofessions Code, is available upon request when this application is submitted or at the following Web site:http:/Iwww.leginfo.ca.gov/calaw.htmi. of Property Owner or Authorized Agent Date
.ICENSED CONTRACTOR'S DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of�L�iayision 3 of the Business and Professions Co and my license' in full force
nd effect. License Class License No Dat 0 Z Contractor Signature
VORKER& COMPENSATION DECLARATION
ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINER UP TO ONE HUNDRED T SAND DOLLARS ($100,0001, IN ADDITION TO THE
OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
hereby affirm under penalty of perjury one of the following declarations:
I have and 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 the
311f7mance of the work for which this permit is issued. Policy No.
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'
carrier and policy number are:
Policy Number Expiration Date
of Agent
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, and agref
t, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
nature of Applicant �( / / DatesL
CLARATION REGARD G C STRUCTION LENDING AGENCY
:reby affirm under penalty of perjury that there is a construction lending agency for the performance of the work forwhich this permit is issued (Section 3097, Civil Code).
Ider's Name Lender's Address
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 zed counenter t above -identified propertviDcinspection purposes. ���. / e.. 2
nature of Prooertv Owner or AuthoriAgent NiV '�—�— a�lnr o�...,on„ rn.., .. ,., n, al.,..;,ea n...,- ni,..,.,ir ? 5 v1J (WI _3A,
ACTION
DATE
BY
`DECLARATION OF COMPLIANCE WITH CODE OF FEDERAL
FOR OFFICE USE ONLY
REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE
1403
PERMIT EXPIRED
_
LJISuRMIrrEDASnES7O^ NOTI. IC:,TIOI, TO
PERMIT CANCELLED
EPA _
PERMIT EXTENDED
QM D
PERMIT FINAL
ASBESTOS NOTIFICATION 15 NOT APPLICABLE TO
CERTIFICATE OF
_
7
PROPOSED DEMOLITION
OCCUPANCYISSUED
SIGNATURE: