HomeMy WebLinkAboutXR2022-2815 - Permit ApplicationPrint Form ~—Worksheetfor Electrical/Mechanical/ Plumbing Appli-e6fian --
City of Newport Beach
Building Division
1. Project Address (Not mailing address)
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Building Permit No.
r 2. Owner's Name V Last S
Ownt(e�'r's�
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Owner's E-mail Address j✓I IA. f "off"
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First
PA State Zip
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r 3. Applicant's Name Last J L First
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Applicant's Street Addres
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Telephone t) S ),Applicant's E-mail Address
r 4. Contractor's Name Last First
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Conttraacc�toes Street Address ry -- l- ----- �
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Zip
Telephone _ �.- ?(contractor's E-mail Address Lnc,_ _ _Ll%r'1l ifs nes�U,# -_� , 7� 0_!;O
Mechanical
Furnace Quantity
up to 100,000 btull
over 100,000 btuF—
wall/floor heaters
Heat Pumps/Package Units
up to 100,000 btuF —
up to 1,000,000 btu:r—
up to 1, 750,000 btul—
> 1, 750,000 btu--
Boilers/Compressors
up to 3 HPI
3 HP-15 HPI
15 HP-30 HPF_-
30 HP-50 HPF
>50 HPf—
Air Handling Units
up to 10,000 CPMI-
> 10,000 CFMI-
VAVBoxI
Repair/Alter/Add HVAC
Numberof Zones
Ventilation
Bathroom FanF_—
Exhaust Fans
Attic Exhaustf—
Residential Hood
Commercial Hoodi—
Metal Fireplace:F--
Gas Linel
Fire DampersF—
Electrical
New Construction Quantity
1 &2 Family S.Ff__1
Multi Family S.F:F__'.'
Receptacle, Switch Lighting Outlets
Total
Lighting Fixtures
Total Fixtures:
Total Low Voltage:F-:
Separate CircuitFl.
Motors/Transformers
0-1 HP or KVA:F--
1-10 HP or KVAf-
10-50 HP or KVAF-
50-100 HP or KVAFl
Over 100 HP or KVA:1
Signs
One branch circuit
Add'I branch circuit:F—
Service
0-600V not over 200A:r!
0-600V & over 2004 —
over 600V:r-
Temp PP/Piggy Back:F—
Sub Panel:F-7—
Other:
v
Bathroom Quantity
Plumbing Quantity
Water closet(toilet)C—'
Backflow device up to 2"r—.
Bidet f —',
Backflow device over 2"F
—;
urinal F
Regulatorsf—
Bath Tubl
Lawn Sprinkler System:F—
Shower stall
Roof drainsf—
Lavatory (basin)I`'
Hose bibbf—
Hydro-massage tubf
Drinking fountainf—
Kitchen
Kitchen sink
Grease trapF—
Garbage Disposal
Grease interceptor
Barsinkf—'.
P-trapF—
Sewer
Vegetable sink
New sewerF—
Dishwashel
Sewer alter/repairF—
Laundry/washing trap—
Sewer abandonment_
Ice makerf—
Floor sinkF—
Miscellaneous
Floor drain(
Water oioinai
Water
Lavatory (basin)i-
Gas Sys up to 4 outlets f
Gas Sys # of outlets over 4l-