HomeMy WebLinkAboutE2022-0922 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application a�WPo,
City of Newport Beace�
Building Division e4nJJ-o0Jzz " • l
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1. Project Address (Not mailing address) Building Permit No. �= 2fJ2`L bg22
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� Floor F Suite
F 2.Owner's Name Last / First
Owner's Street AddressLLv
City State Zip
Telephone Owner's E-mail Address
3. Applicant's Name Last Z First I /L sCZtls L.
Applicant's Street Address
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Telephone �G� �2) - W Applicant's E-mail Address 65 A'Q •
4. Contractor's Name Last 1 -7'f6 ,41UANO0Z First jtil; `ivEG State Lic #
Contractor's Street Address
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Telephone Z`7�� -� �`�j Contractor's E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btu _i7—
over 100,000 btu::s
wall/floor heaters:r —
Heat Pumps/Package Units
up to 100,000 btu::_
up to 1,000,000 btu:F
up to 1, 750,000 btu::®
> 1, 750,000 btu..F —
Boilers/Compressors
up to 3 HP:r—
3 HP-15 HPF� u
15 HP-30 HP:-
30 HP-50 HP:f -w.c-
>50 HP::@
Air Handling Units
up to 10,000 CFM:F
> 10,000 CFM:�
VAV Boxa
Repair/Alter/Add HVAC
Number of Zones:[_
Ventilation
Bathroom Fan:F—
Exhaust Fan::
Attic Exhaust :I
Residential Hood:F_
Commercial Hood:) -��-
Metal Fireplace
Gas Line:: -
Fire Dampers::
Electrical
New Construction Quantity
1 & 2 Family S.F::—
Multi FamilyS.F:I
Receptacle, Switch Lighting Outlets
Total Outlets::
Lighting Fixtures
Total Fixtures:: —
Total Low Voltage:F�
Separate Circuit:!
Motors/Transformers
0-1 HP or KVAF
1-10 HP or KVAF
10-50 HP or KVA:7
50-100 HP or KVA:—
Over 100 HP or KVA:F
Signs
One branch circuit:
Add'I branch circuit
Service
0-600V not over 200A::-
0-600V & over 200A:.
over 600VT_
Temp PP/Piggy Back::
Sub Panel-7
Other
City , , �jst�C� State (k7 Zip , � Z(%�
- L I I --
Business Lic# 6'TO`1gi3�
Bathroom Quantity Plumbing Quantity
Water closet (toilet):
Bidet::
Urinal:_
Bath Tub:: -
Shower stall:
Lavatory (basin):
Hydro -massage tub:F
Kitchen
Kitchen sink :F
Garbage Disposal:
Bar sink:?
Vegetable sink:
Dishwasher-
Laundry/washing trap::
r—
Miscellaneous
W;
Lai
Gas sys ul
Gas sys # of c
Backflow device up to 2":F-®
Backflow device over 2"-F
Regulators:
Lawn Sprinkler System:: -
Roof drainsr�
Hose bibb::—
Drinking fountain:r—
Grease trap:F_
Grease interceptor::
P-trap::—
Sewer
New sewed`
Sewer alter/repair:—
Sewer abandonment:F
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