HomeMy WebLinkAboutE2022-0576 - Permit ApplicationPrint Form WorKsneet for tlectrlcal/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1.oProojeecctt Address (Not mailing address) Building Permit No.
/ D(%o 1 IA S Floor F— Suite
r 2.Owner's Name Last Ic5 haw
Owner's Street Address
' o co ArQ t 0. City ri
Telephone Owner's E-mail Address FAli o S
r 3. Applicant's Name Last al4cr _ First
A licant's Street Address
First Kama E)
State r7,A— Zip 2(p
3185 lTtrwq _Avt, city bi-,,, l`h Z7S _State Fa Zip "LI �%1Q2_ (v
Telephone r7(6l_��r`l�" Applicant's E-mail Address �Q,)1h. butld4U unt-YCOIrf- - - -.
r 4. Contractor's Name Last Ir i �d First _ State Lic #
Contractor's Street Address
Telephone — Contractor's E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btu) —
over 100,000 btur—
wall/floor heaters) —
Heat Pumps/Package Units
up to 100,000 btur—
up to 1,000,000 btuF—
up to 1, 750,000 btu
> 1, 750,000 btu)—
Boilers/Compressors
up to 3 HPF—
3 HP-15 HPIr-
15 HP-30 HPr-
30 HP-50 HPI—
>50 HPf_
Air Handling Units
up to 10,000 CFM)—
> 10,000 CFMF�
VAV Boxr—
Repair/Alter/Add HVAC
Number of Zonesr—
Ventilation
Bathroom FanF—
Exhaust Fan r—
Attic Exhaust) —
Residential Hoodr—
Commercial Hoodr—
Metal Fireplace
Gas Line) —
Fire Dampersr—
Electrical
New Construction Quantity
1 & 2 Family S.F:F—
Multi Family S.F:F--
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total Fixtures
Total Low Voltage
Separate Circuit
Motors/Transformers
0-1 HP or KVAr
1-10 HP or KVA)
10-50 HP or KVA)
50-100 HP or KVAr
Over 100 HP or KVAF—
Signs
One branch circuit
Add'I branch circuit)
Service
0-600V not over 200A:)
0-600V & over 2004—
over 600Vr
Temp PP/Piggy Back
Sub Panel:)
Other
City State F_ Zip
Business Lic# F_
Bathroom Quantity
Water closet (toilet)
Bidet
Urinal r
Bath Tub)
Shower stall
Lavatory (basin)
Hydro -massage tub
Kitchen
Kitchen sink
Garbage Disposal
Bar sink
Vegetable sinkf —
Dishwasher7
Laundry/washing trap
Ice maker
Floor sink
Miscellaneous
Floor drain
Water piping
Water softener
Water heater
Lavatory (basin)
Gas Sys up to 4 outlets)
Gas Sys # of outlets over 4)—
Plumbing
Quantity
Backflow device up to
Backflow device over 2"_
Regulators[ --
Lawn Sprinkler System
Roof drains,.
Hose bibbi-7
Drinking fountain[ --
Grease trap
Grease interceptor
P-trapf—
Sewer
New sewer
Sewer alter/repair
Sewer abandonment
6 7 r� - O5`/
0