HomeMy WebLinkAboutX2015-2206 - Permit Application(����� .� I�e vKS 1 ov �e (-fie GAS �1�i ��'R, � �SE✓us/G� �� (�C�- �
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Worksheet for Electrical/Mechanical/ Plumbing Application a�WPORT
City of Newport Beach °�
Building Division t
Cq<I FO RN`P
1. Project Address (Not mailing address) Building Permit No.
?'7 J��ocA �0ck rlqce Floor Suite
2. Owner's Name Last tf i X 56CA_ A 471
Owner's Street Address
�$ ir4) r✓&Zoo__ _Lac_e __. City
Telephone a Owner's E-mail Address F a -®�
F_ 3. Applicant's Name Last / i 1C �vl. �✓l f �y f Gl tAst� t - First
Applicant's Street Address
StateF�r Zip 2 city /1%toGf/�O -_._ 6,Y
Telephone yy�j j �2 77 Applicant's E-mail Address �D1q�iS i lkeA@ h Pq,P V,0ur' Cps
4. Contractor's Name / �,l rJ
Last Cjp14E'�ICI I G� UI�'�� � C�C�(`�P�Vj �T'� � lr� v� State Lic # ;� L 2 1-7
Contractor's Street Address
+ i ✓L f�1
Tcionhnno eiCl
r
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btu:
wall/floor heaters:
Heat Pumps/Package Units
up to 100,000 btu:,
up to 1,000,000 btu:!
up to 1, 750,000 btu::—
> 1, 750,000 btu:i J
Boilers/Compressors
up to 3 HP:i
3 HP-15 HP:[ —
15 HP-30 HP:�
30 HP-50 HP::
>50 HP IF
Air Handling Units
up to 10,000 CFM
> 10,000 CFM:____ v--
VAV Box _
Repair/Alter/Add HVAC
NumberofZones:!
Ventilation
Bathroom Fan:
r --
Exhaust Fan:
Attic Exhaust:! y
Residential Hood:r---
Commercial Hood:
Metal Fireplace:
Gas Line:
Fire Dampers)) -_
First
State
.� zip!
City ��1<f i S State
pf,� e c GC i Vi c E b s
Electrical
New Construction Quantity
1 & 2 Family S.F:
Multi Family S.F:r
Receptacle, Switch Lighting Outlets
Total Outlets. `—
Lighting Fixtures
Total Fixtures: -
Total Low Voltage:
Separate Circuit::— -
Motors/Transformers
Signs
0-1 HP or KVA:
1-10 HP or KVA:! u�
10-50 HP or KVA'v.
50-100 HP or KVA:,
Over 100 HP or KVA:)
One branch circuit:3
Add'I branch circuit)
Service
0-600V not over 200A 1
0-600V & over 200A:
over 600V:j
Temp PP/Piggy Back:1
Sub Panel:
Other:)
Bathroom Quantity
Water closet (toilet):]
Bidet:F_
Urinal l
Bath Tub:: —
Shower stall:[ ----
Lavatory (basin):
Hydro -massage tub:;
Kitchen
Kitchen sink l
Garbage Disposal:1
Bar sink:
Vegetable sink-F
Dishwasher:_
Laundry/washing trap:
Ice maked _.
Floor sink:!
Miscellaneous
Floor drain:
Water ,r
piping:,
Water softener:!
Water heater:r -
Lavatory (basin):! —-
Gas sys up to 4 outlets:1
Gas sys # of outlets over 4:__
zip 7�
Plumbing
Quantity
Backflow device up to 2":�
Backflow device over 2'T1
Regulators"
Lawn Sprinkler System.F —
Roof drains:1--_
Hose bibb:f�
Drinking fountain::
Grease trap:F_
Grease interceptor:--
P-trap:11- -,- __
Sewer New sewer: . -
Sewer alter/repair:
Sewer abandonment:F --
1 W_ 12"