HomeMy WebLinkAboutXR2023-0712 - Permit ApplicationPrint Form
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Worksheet for Combo Building & Solar Permit Application
Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
F-Building [ Grading F-Drainage [ Elec F_ Mech F- Plum Cu Yd Cut Cu Yd Fill
Project Address (Not mailing address) C Flood Fire r Liq r Landslide [N/A Floor Suite No
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Description of Work
Use F— ConstType
t I
Q lei [L f,,Lfot l l as Inn � S l d
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# StoriesF_ # Units (if Res)F
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L/ (�f✓elf?
Valuation $ FA
Material/Labor
New/AddSF� RemodelSF� Garage/New/Add—
OWNER'S NAME Last-�«�._____-..___ First
Owner's Address Owner's E-mail Address
City _ �f . State FCV Zip �— TelephoneF_—
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APPLICANT'S NAME Last Dv w First -
Applicant's Address Applicant's E-mail Address
1_!4115 ��,{n/JSLCi ��C-[LILZQr?.rC�°H
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City State
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_10u��o w CJLU� - C GF . _ Zip � rL%� Telephone 7l �9LSl Z(�
ARCHITECT/DESIGNER'S NAME Last First Lic. No. �—
Architect/Designer's Address Architect/Designees E-mail Address
City State �— Zip F Telephone
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ENGINEER'S NAME Last First Lic. No.�' -
Engineer's Address Engineer's E-mail Address
City State F® Zip TelephoneF—
CONTRACTOR'S NAME/COMPANY �.y�i �� Class G-q 7
��S P Enos--�r�t�r)Sccp�- Lic. No. -_ _ _
Contractor's Address Contractor's E-mail Address
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Ca n�_
City �oQA�� .Go, - State F< � Zip q.;z9fLf3 Telephone(21L() pl-s-i2�6
SETBACKS REAR SETBACKS FRONT PERMIT NO. �Z
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO "-
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
AA0.v\�) L i'"c-�
2. Owner's Name Last
Owners Street 1Address 1
S ,tA6k1-t\.W-_C_i�fL
Telephone F_ Owners E-mail Address F_
Floor Suite
First LEI\ [ice V Q-�v
City I �u
Stile rl;�F Zip ----
r 3. Applicant's Name Last �XiNL'!1'J k� First
Applicant's Street Address n cttnn�
City IGCZ uV��State Zip I rj
Telephone L71 q ) f i-5yL / Applicant's E-mail Address C �- LgvliJ
lcas O; vs , �' t, yL(InoO-CO
4. Contractor's Name Last , , tl 5 First I State Uc It �—
Contrauor's Street Address
City CIY,t�L State ZiPI
Telephone G� Contractor's E-mail Address - `_N� Business Hc# r-----
7 /-s-r2c - %Gaut-.�,
Mechanical
Furnace Quantity
up to 100,000 btu:over 100,000 btu:r—
wall/Floor heaters:.r—
Heat Pumps/Package Units
up to 100,000 btu:r—
up to 1,000,000 btu �7—
up to 1, 750,000 btu:r—
> 1, 750,000 btu:r®
Boilers/Compressors
up to 3 HP:r--
3 HP-15 HP,�-
15 HP-30 HP;
30 HP-50 HP'lr—
>50 HP:r—
Air Handling Units
up to 10,000 CFM:��
> 10,000 CFM:I
VAV Box:r—
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fan -
Exhaust Fan.
---
Attic Exhaust:i
Residential Hood:r
Commercial Hood:
Metal Fireplace f —
Gas Line:[ —
Fire Dampers F_
Electrical
New Construction Quantity
1 & 2 Family S.F:r_
Multi Family S.F:r—
Receptacle, Switch Lighting Outlets
Total Outlets :F-5:
Lighting Fixtures
Total Fixtures:r—
Total Low Voltage:r g
Separate Circuit
Motors/Transformers
0-1 HP or KVA:r_
1-10 HP or KVA
10-50 HP or KVA�-- 7
50-100 HP or KVA
Over 100 HP or KVA:r—
Signs
One branch circuitr—
Add'I branch circuit:
-
Service
0-600V not over 200A:r_
0-600V& over 200A:7J
over 600V;i
Temp PP/Piggy Back:,
Sub Panel.,
Otherr—
Plumbing
Bathroom Quantity
Water closet (toilet):
Bidet
Urinal
Bath Tub., F_
stall'
Lavatory (basin):�—
L
Hydro -massage tub:r—
Kitchen
Kitchen sink
Garbage Disposal:,F—
Bar sink F_
Vegetable sink:r—
Dishwasherr—
Laundry/washing trap:r+
Ice maker.
Floorsink:r—
Miscellaneous
Floor drain:
Water piping:1r—
Water softener f —
Water heaterr—
Lavatory (basin)::
Gas sys up to 4 outlets:I
Gas sys a of outlets over 4:r—
Quantity
BackBow device up to 2::-
Backflow device over 2":i
Regulators;,
Lawn Sprinkler System:
Roof drains],
Hose bibb:r —
Drinking fountain:r—
Grease trap:r—
Grease interceptorr—
P-trap:r—
Sewer
New sewer: r
Sewer alter/repair:rJ
Sewer abandonment
dimcl
JA Nov aP�,
tV
* p, 060
-vim' in
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