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Home My WebLink AboutP2021-0522 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application ?EW�R> PHnt Form City of Newport Beach 6 m U Building Division ~<,�oa�'= 1. Project Address (Not mailing address) [ Building Permit No. 10 1'j� JL, W rrr.�� 3' ._ .Floor �— Suite — r 2.Owner's Name Last L t G� �- First _ t Ye_, Owner's Street Address City State [C_^t Zip `?.Z_G( Telephone '-`j._G5� ji�.�_. Owner's E-mail Address--.-- r 3. Applicant's Name Last s G .;,. First A licant's Street Address C State �i {�. ZIP�(z �(. 6 7 C�Ty l,� Telephone '`�)�;.V JZ 'n)w Applicant's E-mail Address a,�'44"'-0 -- — - First State Lic# F- 4. Contractor's Name Last --- Contractor's Street Address City State F_ Zip F_.- Telephone 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 btuF > 1, 750,000 btuF — Boilers/Compressor up to 3 HPr- 3 HP-15 HP-�- 15 HP-30 HPr- 30 HP-50 HP)_ >50 HPF— Air Handling Units up to 10,000 CFMF_ > 10,000 CFM) VAV Box__ Repair/Alter/Add HVAC Number of Zones) — Ventilation Bathroom Fan Exhaust FanF — Attic Exhaust) — Residential Hood) — Commercial Hood) — Metal Fireplace) — Gas Line) Fire DampersF_ Contractor's E-mail Address Electrical Quantity New Construction Quantity Bathroom 1 & 2 Family S.F�_ Multi Family S.Fr— Receptacle, Switch Lighting Outlets Total outlets) — Lighting Fixtures Total Fixturesf — Total Low Voltage_ Separate Circuitr— Motomrrransformers Signs 0-1 HP or KVAf- 1-10 HP or KVAf- 10-50 HP or KVAf- 50-100 HP or KVA1— Over 100 HP or KVAI_ One branch circuitF— Add'I branch circuitl— Service 0-600V not over 200AF 0-600V & over 200A1— over 600VF Temp PP/Piggy Back_ Sub Panelr— Otherr— Water closet (toilet): Bidet f — Udnal :r Bath Tubf— Shower stall Lavatory (basin): Hydro -massage tub) Kitchen Business Lic # Plumbing Quantity Kitchen sink �— Garbage Disposal: Bar sink Vegetable sink Dishwasher Laundry/washing trap) Ice makers Floor sink Miscellaneous Floor drains Water piping:F_ Water softeners Water heaters Lavatory (basin) Gas sys up to 4 outlets) Gas sys # of outlets over 41 Backflow device up to 2")- Backflow device over 2"r_ Regulators) — Lawn Sprinkler Systemf— Roof drains:r Hose bibb)— Drinking fountain_ Grease trapl— Grease interceptor) P-trap:f— Sewer New sewerf— Sewer alter/repair: Sewer abandonments