HomeMy WebLinkAboutE2017-0132 - Permit Applicationu0c ) X S (7J �t' ZL/lGZ KCAL) 4,1110,
Worksheet for Electrical/Mechanical/ Plumbing Application �EWeoRr
City of Newport Beach
Building Division " e,
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1. Project Address (Not mailing address) Building Permit No.
l - - S i Floor I Suite
F 2.Owner's Name Last First
Owner's Street Address -- -
City State r— Zip
--Telephone -- -- - Owner's E-mail Address - ----- - --- -.
r 3.Applicant's Name Last First
A licant's Street Address
City F State Zip �—
Telephone
r 4. Contractor's Name Last
Contractor's Street Address
Telephone
Mechanical
Furnace Quantity
up to 100,000 btu.r
over 100,000 btu:r
wall/Floor heaters:re
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:r—
Boilers/Compressors
up to 3 HP:r--'.
3 HP-15 HPF__
15 HP-30 HPrs"'.
30 HP-50 HP:r
>50 HP:r--
Air Handling Units
up to 10,000 CFM:r
> 10,000 CFMr
VAV Box:-•••.
Repair/Alter/Add HVAC
Number of Zones:-.
Ventilation
Bathroom Fan:r
Exhaust Fan:y—
Attic Exhaust
Residential HoodF
Commercial Hood:
Metal Fireplace
Gas Line:y
Fire Dampers:r
Applicant's E-mail Address
Contractor's E-mail Address
Electrical
New Construction Quantity
1 & 2 Family S.F:F--
Multi Family S.F:r—
Receptacle, Switch Lighting Outlets
Total OutletscF
Lighting Fixtures
Total Fixtures:r
Total Low Voltage:-°•••.
Separate Circuit:r
Motors/Transformers
0-1 HP or KVAF_
1-10 HP or KVA:r
10-50 HPorKVA:r-
50-100 HP or KVAJ
Over 100 HP or KVAF__'
Signs
One branch circuity♦
Add'I branch circuit
Service
0-600V not over 200A:r
0-600V& over200A:�
over 600V:r--
Temp PP/Piggy Back
Sub Panel:- Z
Other
First State Lic# �—
CiTy F— State F_ Zip F_
Business Lic #
Bathroom Quantity
Plumbing Quantity
Water closet(toileUr
BackRow device up to 2":yi
Bidet:
BackRow device over 2":F
Urinal :y—LL
Regulators
Bath Tub:
Lawn Sprinkler System :r—
Showerstall:�
Roof drains:
Lavatory(basiN:y—
Hose bibb:F—
Hydro-massagetub:y— Drinking fountain :r—
Kitchen
Kitchen sink:-_
Garbage Disposal:
Bar sink:y--
Vegetable sink :r—
Dishwasherr—
Laundry/washing trap:-
Ice maker.-
Floorsink:r—
Miscellaneous
Floor drain :r—
Water piping:r—
Water softener. r—
Water heater:-_
Lavatory(basin)
Gas Sys up to 4 outlets:
Gas sys # of outlets over 4:r—
Grease trap:r—
Grease interceptorr—
P-trap:r
Sewer
New sewer:-`
Sewer alter/repairr—
Sewer abandonment:F_