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MECHANICAL
10. Does the work include any refrigeration equipment?
11. Does the work include new rooftop equipment weighing a total of 250 lbs.
or more?
12. Does the work include altering the existing smoke detection system in the
air plenum?
13. Does the work include duct work with fire and or smoke dampers or duct
extensions over 25 feet?
14. Are there any new installations containing a commercial type kitchen
hood, Types I or ll?
ELECTRICAL
15. Does the work include a new service, sub panel, or transformer rated
over 400 amps?
16. Does the work involve more than 5 branch circuits?
17. Indoor lighting: Any new or replacement lighting over 50% of the existing
lighting in the area?
18. Outdoor lighting: Any new or replacement lighting over 50% of the
existing luminaries in a permitted area?
19. Does the work involve any high voltage installations (over 600 volts)?
NO YES
ar ❑
NO YES
® ❑
ITEMS NOT ELIGIBLE FOR M.E.P. PLAN REVIEW WAIVER
PLUMBING
• New restroom facilities
• Septic tanks, cesspools
• Chemical waste
• Combination waste & vent
MECHANICAL
• Boilers
• Spray booth
• Fire and/or smoke damper
• Medical gas system
• Medium pressure gas
piping
I certify that the amboovee information is true and correct.
Signature: "
Print Name:
Phone #:
Chris Dirpes
949-852-1491
FormsWOMMERCIAL MechanicalElectricalPlumbingPlanCheckQuestionnaim
2
ELECTRICAL
• OSHPD 3 uses
• Dock or harbor power
• Photovoltaic or standby
generator
• Fuel cells
Date: 12.05.2018
Vn C)I2- 2 -?(,P 3
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www,newportbeachca.gov 1 (949) 644-3200
COMMERCIAL
MECHANICAL, ELECTRICAL, AND PLUMBING
QUESTIONNAIRE FOR PLAN REVIEW WAIVER
Job Address: 5000 BIRCH STREET, SUITE 4400, NEWPORT BEACH, CA
The above -proposed project may require electrical, mechanical, and or plumbing plan checking.
The following questions are regarding the new proposed work and the applicable areas it
serves. If the answer to a question below is "YES," a plan check is required for the Electrical,
Mechanical, and/or Plumbing portion of work. To expedite the permit process, please submit
this questionnaire along with an application and three (3) sets of plans.
NOTE: The Chief Building Official may make exceptions for minor work, additions, and
alterations.
COMMERCIAL TENANT IMPROVEMENTS ONLY
GENERAL
NO
YES
1. Is the area of work more than 2,500 square feet?
❑
❑
2. Is the area of work for OTHER THAN an occupancy classification and
❑
❑
(use) of B (office), or M (retail)?
3. Does the area of work require a concurrent review from any other City
❑
❑
department or outside agency (i.e. Health, Fire, or Public Works)?
PLUMBING
NO
YES
4. Does the work include more than 9 plumbing fixtures?
❑
5. Is the potable water piping 2 -inches or greater?
❑
6. Does the work involve the installation of any pumps?
®
❑
7. Does the work include a gas system other than typical low pressure
❑
❑
system?
8. Are there any installations, alterations, or relocations of a grease
❑
interceptor and or clarifier?
9. Is the plumbing work above the ground floor in a high-rise building?
❑
'®
x2DIg 3 (P 13
CITY OF NEWPORT BEACH t3OO ® 1:3 1 r- C," Sfi.
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
HAZARDOUS MATERIALS QUESTIONNAIRE
If the answer to any of the questions below is yes, applicant must contact the Fire Prevention Office, 100 Civic
Center Drive, P.O. Box 1768, Newport Beach, CA 92658-8915. Telephone: (949) 644-3106.
Business Name Contact Person Telephone
SPEC SUITE 4400-4500
Mailing Address City State Zip
Site Address City Zip
5000 BIRCH ST. NEWPORT BEACH, CA, 92660
YES NQ
1. ❑ Jfl Will your business activity generate Hazardous Waste in any quantity, in any physical
form (solid, liquid, gas)?
2. ❑ Will your business at any one time store, use or handle Hazardous Substances in
quantities
equal to or greater than 55 gallons, 500 pounds or 200 cubic feet of compressed gas?
3. ❑ Will your business store, use or handle Carcinogens or Human Reproductive Toxins in
any amount?
4. ❑ Will your business use an existing or install an Underground Storage Tank for
Hazardous Substances or Hazardous Wastes?
5. ❑ Will your business store, use or handle Acutely Hazardous Materials?
6. ❑ iK If your business will be handling Acutely Hazardous Materials, will your business be
located within 1,000 feet from the outer boundary of a school?
Briefly describe the nature of the business activity: BUSINESS OFFICE
Printed Name of Respondent: Circle one: owner lessee agent
tenant architect engineer
I declare under penalty of perjury that to the best of my knowledge and belief the responses made herein are true
and correct.
11/26/2018
Signature of Respondent Date
For NBFD-Fire Prevention Use Only YES NO Reviewed By: Date:
Business Plan Required ❑ ❑
Plan Check No.
Forms\Hazquest 3/11/09