HomeMy WebLinkAboutUntitled _ $t City of Arcadia, CA
Permit NO TI 19 0162:
F P Development Services Department ii ?cL?Lffti
1Pem![typeTenant ImprovementBox 60021 f+ „`._;. I. Work Cf9ssficohoni'Tenant Improvement
(626)574-5416 - - c a- Permit Status:Issued
ARCADIA - Issue:Date:04/11/20191 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
733 W Naomi AVE k Arcadia,CA 5383035030
Contacts
BALDWIN ARCADIA CENTER LP Owner ARVIN LAM Applicant
815 W NAOMI AVE A,Arcadia,CA 91007
(626)382-9887
J P SERVICE INC Contractor
2714 STINGLE AVE AVE,ROSEMEAD,CA 91770
(626)572-9181 642751
essscil rite]
riiption.T.I.MENYA HANABI RAMEt�•'"'Reyiseditdrmclu'•c�e'`� - Valuation: $ 100,000.00 . Tenant MENYA HANABI RAMEN
Total Sq Feet: 0.00 Plan Check#19-162 Plan tl 16
Fees Amount Ix payments Amount Paid
Accessibility Plan Check $119.34 Total Fees $3,812.21
Accessiblity Building Permit $122.40 Cash/Receipt IS REC-00934-19 $1,631.66
Add/Alter Ducts $9.94 Cash/Receipt If REC-00217-19 - $1,519.30
Building Issuing Fee $47.01 Cash/Receipt tt REC-01312-19 $661.25
Building Permit Fees $1,224.00
Building Plan Review Fee $795.60 Amount Due: /t $0.00
gel P, p, i�fp�
Cal Green Plan Check $79.56 V, it
Commercial T.I.Fire Plan Chk. $280.00 B
Electrical Permit Issuance Fee $47.01
Energy Plan Review Fee $244.80
Evaporative Cooler(Not portable) $19.86 CALLS FOR INSPECTIONS
Fire Final Occupancy Fee $200.00 Request for inspection by telephone at 626-574-5450. Leave a message
Floor Drain Fee $52.84 requesting the address,timeframe and what inspection item is needed.
Floor Sink $52.84
Gas System(Outlets) $90.11
Green Building Standard $4.00 This permit/plan review expires by time limitation and becomes null and
Hood Serviced by Mechanical Exhaust $14.96 void if the work authorized by the permit is not commenced within 180 days
Interceptor $26.27 from the date of issuance or if the permit is not obtained within 180 days
Kitchen Sink $66.05 from the date of plan submittal.This permit expires and becomes null and
Lavatories $13.21 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
Light Fixtures $51.68 Arcadia building inspector for a period of 180 consecutive days.
Total: $3,812.21
April 11,2019
Issued By: Date
May 28,2019 Page 1 of 1
I. PERMIT/PLAN REVIEW APPLICATION
'E4il' Development Services Department,240 West Huntington Drive,Post Office Box 60021
'amoau,on, 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. Q I have and will maintain a certificate of consent to self-insure for workers'
License Class G i 275 Exp. Date4/30/2 compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Signature of Contractor
OWNER-BUILDER DECLARATION ❑ 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�wto�rkers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier dV e 'trP�
Re
W
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number W 1 29 2.0
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 there from and the basis for the alleged exemption. Any violation of C 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, forthwith comply with those provisions.
or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for /2t5/ICI
sale(Section 7044,Business and Professions Code:The Contractors License Date r751 Signature /— "r
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 coverageis unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fm es 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 ns provided for in Section 3706 of the Labor Code, interest, and
attomey's fees.
0 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 contacts 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:
_ q Lender's Name
Date���/I 1 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:
I. 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. p
\Name � �J p, /�'itle r' '- 1iV4
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 en PPPPf/��/tpJon the above-mentioned property for inspection purposes. `II
Signature i�r 1 Date 2/19
•
,�b-4,--74. 1 City of Arcadia, CA Permit NO.21149-0162
V 1) Development Services Department fl Permrt Type 'Tenant Improvement
,od "`� 240 West Hunfington Drive,Post Office Box 60021 G^ ^tg
Arcadia,CA 91066-6021 1 i f, I kClassnccation:Tenant Improvement
- 1. ! :1„1;ter
I (626)574-5416 - za -- � ; - PermftStotG"
s:Issued !
ARCADIA Issuexoate 04/ 1/2019'I Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
733 W Naomi AVE Arcadia, CA 5383035030
Contacts
BALDWIN ARCADIA CENTER LP Owner ARVIN LAM Applicant
815 W NAOMI AVE A,Arcadia,CA 91007
(626)382-9887
1P SERVICE INC Contractor
2714 STINGLE AVE AVE,ROSEMEAD,CA 91770
(626)572-9181 642751
Description:T.I.MENYA HANABI RAMEN Valuation: $ 100,000.00 Tenant MENYA HANABI RAMEN
•
Total Sq Feet: 0.00 Plan Check#19-162 Plan# /(o
Fees Amount payments Amount Paid
Accessibility Plan Check $119.34 Total Fees $3,150.96
Accessiblity Building Permit $122.40 Cash/Receipt#REC-00934-19 $1,631.66
Building Issuing Fee $47.01 Cash/Receipt#REC-00217-19 $1,519.30
Building Permit Fees $1,224.00
Building Plan Review Fee $795.60 Amount Due: k
$0.00
Cal Green Plan Check 579.56 —
�Commercial T.I.Fire Plan Chk. $280.00 ,,��,,FF°°��
Energy Plan Review Fee $244.80 /Je��� ,
Fire Final Occupancy Fee $200.00 ea,
,,'ss
Green Building Standard $4.00 it,..
Solid Waste Management Fee $6.25 CALLS FOR INSPECTIONS
Strong Motion Inst.Program Com 528.00 Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
Total: $3,150.96
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.
4:f .
, &/A
U April 11, 2019
Issued By: Date
April 11,2019 Page 1 of 1
1 PERMIT/PLAN REVIEW APPLICATION t
0,4 ___
• 43I, 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 force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
413b12-o a compensation, asprovided for bySection 3700 of the Labor Code, for the
License Class I COI G3(�License No. %Z�Sf Exp. Date P
Signature of Contractor performance of the work for which this permit is issued.
OWNER-BUILDER DE ARATION 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 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 permitto construct,alter,improve, Carrier SATE 94/I/0-
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number Clog rl D(-7 2-O( 9
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 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 ifI s ould become subject to the
workers'compensation provisions of Section 37p t1 f the Labor Code,I shall
❑I, as owner of the property, forhwi mply ith those provisions. j
or my employees with wages as their sole
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 Z q• 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 are not intended or offered for WARNING: Failure to seam orkers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)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 costof 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:
I. 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. o,,/ ,,
Name (& C v ✓l Title CONTRA C 7O6C .
PRINT NAME
I certify that I have read this applicatio : ' 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 ornan • and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the above- ention,d property for inspection purposes. �7
Signature - / Date 4/(/i//9
'-►
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp. X33 i / J4-op&
100. Setbacks 210. Under ft./bldg.drain 5-2-19 id.
101. Rough grade 211. Copper underslab
102. Figs.&forms / 12. Rough plumbing {.,.1� Wc-ey-r,;--V
�gy�E[c'a ice. C,✓ C,GF�S
103. Pre-slab ‘-toe-/T 213. Rough gas J
104.. Floor joists 214. Shower pan Gn1C-Y. 6K -r . 'Dz1/WAtt }i105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer 5 n5 G, SG>Q•8 Dowat5 !k rile
108. Diaph nailing 218. Water service /S 1t en ' 41-1-1
109. Roof nailing 19. Anal gas 6-3-/7 At
110. Framin, 1 l` a 220. Fixtures
111. OcciAreaSeIt.Wall 221. Anal.lumbin. .- MIjsry_/`_del DRywn_- fru". g,I4tS /�
112. Sound
arsridwalls 2. Sewer cap/demo. coRTA"/� tJ/LCL a-N CAleleiG f�7
113. T-bar b-f!9 s/W
Pool114. Insulation-Flr. Inspections
115. Insulation-Wall 240. Excavation/steel Date Insp.
q -yI
116. Insulation-Cell. 241. Rough plumbing LZeN ` 4/-4'1G• /i� u
117. Drywall nailing 242. Lightonding ! r71��'f y r4.{"�y
118. InteriorExterior
lath 243. Underground conduit / c2. / /1`(�-
119. Fxlerior lath 244. P-trap
120. Finish grade � 245. Gas line&test
121. Anal building (0.2/41 O�P----- 246. Fence,gates&signs 4 / rr�
122. Anal demo/lot clear 247. Pool heater ao-� „.... - E S6,C'Cc/73f1 `SSC
248. Anal electric
Electrical Inspections Date Insp. 249. Anal.lumbin. /Sr ,/
150. Power pole 250. Pool cover C-64, ! -I dirt/&e rsr 14-oo
151. Sales lot lighting 251. Pool final Deter Age- t SAP 4-:77
152. Under.round conduit
153. Underslab conduit Retool Inspections Date I Insp. / -- -
154. UFER ground 270. Pre-reroof insp. 6,-1/4"-e" L escrAt/G !v✓ CkIGdivr
155. Water ground 271. Roof framing ea
156. Rough electrical 272. Sheathing nailing L�YE� 6F Avgaf r.
157. Fixtures 273. Anal reroof "0-74. /1- o'/ 7) rr Gr. .�+y
158. G.F.C.I.
159. E..t.bondin! Sign Inspections Date I Insp.
160. Service panel 280. SetbacWoverhang
161. Anal electric ‘-N-1/ eb� - 281. Footing
282. ConduiVwirin.
M• h. i .11 iinIns
i. p "' r
180. Venting/flue 284. Anal sign el L"
181. Furnace/A.C. / i
182. Rouch HVAC ../0 ` An Miscellaneous Insp. Date Insp.
183. Are dampers 290. Are alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers _
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Anal
189. Commercial hood
190. Duct shaft Sewers&Offsite Insp. Date I Insp.
191. Final mechanical Z '#T cin 300. Lateral(main to P/L) -
301. Saddle/V
Block Wall Inspections Date Insp. 302. Cess.00l filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Anal wall 306. Trash bin
.' t = _s = mow " 1as.>Ru2Mw A`r 4as;.wut `FHzu —.. +
/ ^ �A io,,.. ♦.. ... .au
, '
't4t:
%
�P + R ' r ., -,, T4r m 'l �� ff � `♦ � /f \- fN ` - s �V
�� . wWa: ..
Y 4Sk
9} .
t;2
Fes .
t.....".4,•.
C
Alf
S
i.
Certificate of Occupancy H.
City of Arcadia -.
r Development Services Department—Building Division .
This certificate issued pursuant to the requirements of the
1;
California BuildingCode certifying
tsf{m Eying that at the time of issuance this structure was in ;
compliance with the various ordinances of the City regulating building construction or use. ,x
,y /
Permit No. TI-19-0162 , •
..cr64114
•
•
';,:''1V-11:1:41.:'
'.:.": <
7:?...V:
.,t.:7;,,,A.
, . .ziti,) ,,
„ ,_
' 4 : : .1.
' -.-"i" '‘.,'..,
,L. ,i.,14,
I 19-0162
4< Building Address: 733 W Naomi Ave,Arcadia, CA 91007
', Permit Type: Tenant Improvement Effective CBC: 2016 CBC ,e th
/65,,-
Occupancy Code: B Zone Code: C-2
c1(:.
Final Date: 7/8/2019 Type of Construction: TYPE VB, SPRINKLERED
'Nt fr
': c
i IN
d Owner: Baldwin Arcadia Center LP Tenant: MENYA HANABI RAMEN n r
•
,e/<,__((y4
'fi-,,,.41,1":.
a
�'- Kenneth Fieldscial ,. . *},
4 ti +"'+'.
fj9 Post in Conspicuous Place h �. x`O
L. -• —.7--,.-(4C - ..`t -10-00.,0"—4-. �`vy ' m rrJ.;''''tt �Mte-al.'" .-'-- w w., '34,.ffi`S'G.S'PRSYY..5G4R1G' ! fiT .atb \jl_ •
-..'4”L3/4,...j.,..1 /t\\O4,„+4210 ,y,:^ ,1 f 4 ° a ..as 'Arca Is T irI 4 •/Ar C� � .� �� t .�f A� cy�"`� `s.,,,,-..e-t �4 7 ,,,',"'i% [ro i .4.,\,
4. ' '..,.
ilk V ^D94 ,^ ue•w To,..w- , Y - uV 1 n:-"r'3'i *u ...t-a Iv t..,, f`b". ,- /`�'-„. �+r, ..
'
pct° uu,wc COUNTY OF LOS ANGELES • DEPARTMENT OF PUBLIC HEALTH
tzhtcj % ENVIRONMENTAL HEALTH
I+49- d IR: + SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH
} r yf PLAN CHECK PROGRAM-BALDWIN PARK
COUNTY or Losac
kELES
E3uiont t5 5050 COMMERCE DR, BALDWIN PARK, CA 91706 Public Health
PHONE:(626)430-5560
W W W.PUBLICHEALTH.LACOUNTY.GOV/EH
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 07/01/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0173052
PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF)
OWNER/REQUESTER ARVIN LAM,APPLICANT
DBA MENYA'HANABIRAMEN
ADDRESS 733 W NAOMI AVE K-L,ARCADIA, CA 9-1007
FINAL REINSPECTION STATUS: APPROVED
CORRECTIt?NS COMPLETED " , �t ,; itactA
CORRECTION CATEGORY DATE IDENTIFIED DATE CORRECTED
EQUIPMENT/STORAGE 06/26/2019 07/01/2019
FOOD PROTECTION/FOOD STORAGE 06/26/2019 07/01/2019
EMPLOYEE FACILITIES 06/26/2019 07/01/2019
PLAN SUBMITTAL/REMODEL 06/26/2019 07/01/2019
ADDITIONAL REQUIREMENTS
RE-INSPECTION CONDUCTED. ALL VIOLATIONS WERE CORRECTED.
M.E.P.F.AND BLDG. FINALS ON FILE.
THIS FACILITY IS HEALTH DEPARTMENT APPROVED AND ARE OK TO OPERATE.
THE DISTRICT INSPECTOR WILL CONDUCT AN INSPECTION AND ISSUE A LETTER GRADE.
PHP INVOICE WILL BE SENT VIA MAIL.
COMMENTS
NONE
Help us serve you better by completing a short survey.Visit our website at www.oublichealth.lacountv.eov/eh.
Operator Signature Page 1 oil
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 07/01/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0173052
PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF)
OWNER/REQUESTER ARVIN LAM,APPLICANT •
DBA MENYA HANABIRAMEN
ADDRESS 733 W NAOMI AVE K-L,ARCADIA, CA 9-1007
DISCLOSURES
It is a misdemeanor violation to begin operation without a valid Public Health Permit/License.The Public Health
Permit/License will be issued by the Los Angeles County Department of Public Health Environmental Health Division(DPH-EH)
Plan Check Program at the job site following final inspection and approval by all applicable agencies. Remodeled areas of an
existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies prior
to use.
Any future alteration,construction,building,renovation,repair,change of equipment,change of the operation of a food
facility/establishment or change of menu may require plans to be submitted to the DPH-EH Plan Check Program. Additional
approvals may be required from other enforcement agencies.
It is improper and illegal for any County officer,employee or inspector to solicit bribes,gifts or gratuities in connection with
performing their official duties. Improper solicitations include requests for anything of value such as cash,discounts,free
services,paid travel or entertainment,or tangible items such as food or beverages. Any attempt by a County employee to
solicit bribes,gifts or gratuities for any reason should be reported immediately to either the County manager responsible for
supervising the employee or the Fraud Hotline at(800)544-6861 or www.lacountyfraud.org. YOU MAY REMAIN ANONYMOUS
Public Health Permit/License:
A separate fee is required for the Public Health Permit/License.A billing statement will be sent to the permit/license holder
annually by the DPH-EH. The fee is required to be paid to perform or carry on,conduct or engage in any mobile food facility
listed in Los Angeles County Code,Title 8,Section 8.04.720.
State and Local Licenses and Permits:
Contact the State of California and your local city hall regarding additional license and permit requirements.
Restrooms:
Customer may use restroom facilities if they are located in a customer area.Customers may not enter the food preparation
area,food storage area,or the utensils washing/storage areas in order to access the restrooms.All food,utensils and
equipment must be protected from contamination.
Routine Inspection:The DPH-EH conducts routine inspections of all food facilities in Los Angeles County. Following the
issuance of your Public Health Permit by the Plan Check Program,an Environmental Health Specialist from your local district
will conduct an inspection of your facility. If your Business is located in a city that has adopted the grading ordinance,the
inspector will post a grade or score card at your facility. Grade/Score cards are not issued by the Plan Check Program.
Help us serve you better by completing a shod survey.Visit our website at www.publichealth.lacounty.ov/eh.
Operator Signature Page 2 of 2
. .
‘,,t OFIOS,rvv" COUNTY OF LOS ANGELES ' DEPARTMENT OF PUBLIC HEALTH " cic.•
8°s `_^ • . : ENVIRONMENTAL HEALTH
• + ;-11:+ SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH. '
t x� IF° t{ 44 PLAN CHECK PROGRAM-.BALDWIN PARK COUNTY OF.LOS ANGEIES
�,.-,-.N"FP' ,�,- • 5050 COMMERCE DR, BALDWIN PARK, CA91706 'Public Health
PHONE: (626)430-5560 ' .
• 0b MIN PUBUCHEALTH,LA000NTY.GOV/EH .
GP •
e°���a
OFFICIAL PLAN REVIEW REPORT •
DATE H • 05/23/2019 •EHS VIVIAN TAN .
•
PLAN CHECK NUMBER SR0173052
' PROGRAM ELEMENT . 1702-RESTAURANT(501-1,999 SF)
- OWNER./.REQUESTER ARVIN LAM,APPLICANT . .
DBA . MENYA HANABI RAMEN,
ADDRESS 733 W NAOMI.AVE K-L,ARCADIA, CA 9-1007 •
INITIAL MODIFICATION OF APPROVED PLAN
STATUS: APPROVED
ADDITIONAL'REQUIREMENTS ' ' - `
:- THE REVISED,PLANS ARE APPROVED, SUBJECT TO:ON-SITE INSPECTION PRIOR TO OPERATION OR STOCKING
• FOOD ON THE PREMISES. APPROVAL IS CONTINGENT UPON THE FOLLOWING:
1) OBTAIN LOCAL BUILDING DEPARTMENT PERMITS AND APPROVALS.
2) SUBJECT TO ON-SITE INSPECTION AND APPROVAL. ALL EQUIPMENTS MUST BE CERTIFIED OR CLASSIFIED
FOR SANITATION BY AN AMERICAN NATIONAL STANDARDS INSTITUTE(ANSI)ACCREDITED CERTIFICATION ,
PROGRAM OR ANACCREDITED TESTING AGENCY.
3)'ALL USED AND/OR EXISTING EQUIPMENT.AND FINISHES SHALL BE IN GOOD REPAIR AND ARE SUBJECT TO ,
• ON-SITE INSPECTION AND APPROVAL. •
4) ENSURE THAT THE COMMERCIAL HOOD AND MECHANICAL EXHAUST AND MAKE UP AIR SYSTEMS MEET THE
UNIFORM MECHANICAL CODE. ' '
5) READ AND COMPLY WITH THE FOLLOWING ATTACHMENTS REGARDING:- -
A) FINAL INSPECTION NOTICE
B) PLAN APPROVAL CHECK LIST •
C) CERTIFIED.FOOD HANDLERS CERTIFICATE ' - •
6) HEALTH DEPT. APPROVED SET OF PLANS SHALL BE MADE AVAILABLE-SITE AT THE TIME OF FINAL • •
INSPECTION. " •
• THIS APPROVAL IS LIMITED TO THE CHANGES AS DETAILED UNDER THE SCOPE OF WORK: REPLACING CEILING
TOT BAR CEILING-SMOOTH, WASHABLE.
CONTACT VIVIAN TAN AT 626 430-5546NTAN@PH.LA000NTY.GOV TO SCHEDULE A FINAL INSRECTION. •
PROVIDE AT LEAST 3 WORKING DAYS PRIOR NOTICE FOR A FINAL INSPECTION.:
A FINAL INSPECTION SHALL BE CONDUCTED AND A PUBLIC HEALTH PERMIT SHALL BE OBTAINED PRIOR TO '
• OPENING AND OPERATING THIS FOOD ESTABLISHMENT.
•
Help us serve you better by completing a short survey.Visit our website at www.aublichealth.lacountv.00v/eh. •
? .
EHSSignature Page 1 oft
OFFICIAL PLAN REVIEW REPORT
DATE 05/23/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0173052 Pao -
PROGRAM ELEMENT 1702 RESTAURANT(501-1,999 SF) `3
OWNER/REQUESTER ARVIN LAM,APPLICANT eo
DBA MENYA HANABI RAMEN 444f
ADDRESS 733 W NAOMI AVE K-L,ARCADIA, CA 9-1007 4pA
•
COMMENTS
NONE
•
DISCLOSURES:
Prior to construction and approval from the Los Angeles County Department of Public Health Environmental Health Division
(DPH-EH) Plan Check Program, final inspections must be obtained from Building and Safety (mechanical, plumbing, electrical),
and all other enforcement agencies.
Failure to obtain a Public Health Permit/ License prior to operation of the facility/establishment is a misdemeanor violation.
Construction of the food facility/ establishment must be completed and approved within twelve (12) months from the date of
approval to avoid submitting new plans.
A copy of the approved plans must be available at the time of the field construction review.
All utilities must be on and operational at the time of the field construction review.
Please contact your plan check inspector at least 3 days prior to the field construction review.
Two field inspections will be covered under the Plan Check fees assessed upon plan submission.
A charge will be assessed for each subsequent field construction review.
•
•
C
•
•
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacountv.aov/eh.
2
EHS Signature Page 2 of 2
x City of Arcadia, CA _= Perm tNo FIRE=19`0921
�9 Development Services Department f f I ^w' l,--)�c, Permit Type:Fire:
240 West Huntington Drive,Post Office Box 60021 11ff rrr i a r
\\V
.. Arcadia,CA 91066-6021 '^''t ?m i�,� j - ,t'Vork Classification:Fire`Alarm-',
) (626)574-5416 - . Permit Status:Issued
ARCADIA Issue;Datei06/04/2019, Expiration: 11/19/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
733 W NAOMI RD Arcadia,CA 5383035030
Contacts
BALDWIN ARCADIA CENTER LP Owner United Fire Service,Inc' Contractor
815 W NAOMI AVE A,Arcadia,CA 91007 8755 Remmet AVE B,Canoga Park,CA 91304
(818)346-2499 822177
Description:8 NOZZLES FOR MENYA HANABI RAMEN , Valuation: $ 1,700.00 Tenant HENABI RAMEN
0 Total Sq Feet: 0.00 Plan Check#19-791 Plan#
Fees Amount Payments Amount Paid
Fire Extinguishing System Plan Check $280.00 Total Fees $419.06
Fire Issuance $47.01 Cash/Receipt U REC-01406-19 $139.06
Fire Permit Fees $91.05 Cash/Receipt U REC-01300-19 $280.00
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: $419.06
CilipitErfbCALLS 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.
OM
June 04, 2019
Issued By: Date
June 04,2019 Page 1 of 1
:uFoavq'.
giAl ;sem_ 1f PERMIT/PLAN REVIEW APPLICATION
4t*' Development Services Department,240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416,Fax (626)447-9173
moa, ,t4
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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class L-_I' License 82 2 t 7Exp. Date 7-3N`l compensation, as provided for by Section 3700 of the Labor Code, for the
-- performance of the work for which this permit is issued.
Signature of Contractor
0 I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of he 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, Carrier LJc.C(o
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number 1..4^'G ?VI 7/1-1
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
0 I certify that in the performance of the work for which this permit is issued,I shall
exempt there from 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 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
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 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(1)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 CONSTRUCTION LENDING AGENCY
Code:The Contractors License Law does not apply to an owner of property
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
further information. / ,, /
Name Arid 5t A 4t - TfUe
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 / /�
City of Arcadia, CA —Permit FIRE-19 0842
Development Services DepartmentYt ,�`^�fit -, p 1 - Permit Type Fire
240 West Huntington Drive,Post Office Box 60021 'I s .P, r j
Arcadia,CA 9106fi-6021
( 1 } I i :, { F_I
Work'Classification:FireSprinkler'
! s -
(626)574-5416 *"' - Permit Status;Issued
ARCADIA Issue Date:05/15/2019 Expiration: 11/02/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
733 W NAOMI RD Arcadia,CA 5383035030
Contacts
BALDWIN ARCADIA CENTER LP Owner F&H Fire Protection' Contractor
815 W NAOMI AVE A,Arcadia,CA 91007 1119 Westminster AVE,Alhambra,CA 91803
(626)262-3876 584319
Description:FIRE PRINKS FOR HANABI RAMEN 15 HEADS Valuation: $ 1,500.00 Tenant
. �.•._.... P _
TotalSq Feet: 0.00 Pllanan Check N19-842 Plan Hm
Fees Amount" Payments Amount Paid
Fire Issuance S47.01 Total Fees $830.66
Fire Permit Fees $82.65 Cash/Receipt S REC-01213-19 $130.66
Solid Waste Management Fee 2 $1.00 Cash/Receipt it REC-01130-19 $700.00
Sprinkler Heads $700.00
Amount Due: $0.00
Total: $830.66
al COM&
ilgb 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.
/ May 15, 2019
Issued By: Date
May 15,2019 Page 1 of 1
• A.
4�uroa,, •
S PERMIT/PLAN REVIEW APPLICATION
ssT
��Ell'�' 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 -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 forcer� and effect.ggq ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class ct (/O License No. E�C -c- ( Exp. Date _I compensation, as provided for by Section 3700 of the Labor Code, for the
C �/I / performance of the work for which this permit is issued.
Signature of Contractor '`� ab
OWNER-BUILDER DECLARATION EfI have and will maintain workers'compensation insurance,as required by Section
mit
❑ 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 rs are:
License Law for the following reason(Section 70313,Business and Professions is issued.My workers'�mpensatio insurance carrier and oficy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 1Q>ler 1 e p ' o1'-cBsc'7e ��rr C�
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number �F7 W C-� Z / /
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 ❑ I certify that in the performance of the work for which this permit is issued,I shall
exempt there from 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 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
❑ as owner of the property, forthwith corn ly wi th se provisions.
I, or my employees with wages as their sole ' J
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 V (VI
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(1)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.
LII, 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:
I. 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.
W
Name . if n i _A • 1 Title _ (� •
' PRINT NAME {I
4
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. 1 /,/(//�'
Signature 1 Date ���/ t /
OF AR
orpriniNtii
C �
410
00>44%.7
m4°"yoI MEMORANDUM
Fire Department
DATE: June 27, 2019
TO: BUILDING DEPARTMENT
INSPECTOR Henry Kemick
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 733 W. Naomi Avenue, #K& L
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 6-26-2019 Jill Perumean
FIRE ALARMS
HOOD & DUCT 6-26-2019 Jill Perumean
KNOX BOX
OCCUPANCY 6-26-2019 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 6-27-2019 jill