HomeMy WebLinkAboutXC2023-0185 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical) Plumbing Application
City of Newport Beach
Building Division " d
1. Project Address (Not mailing address) Building Permit No.
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Owner's Street Address
City r State F_ Zip
Telephone F— Owner's E-mail Address I
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F_ 3. Applicant's Name Last "¢�J,NA Q q-- First (s - �U / �0D
A licant's Street Address
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Telephone I�Z-cj(�}�S(p� Applicant's E-mail Address
I 4. Contractor's Name Last
Contractor's Street Address
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Mechanical
Furnace Quantity
up to 100,000 btut
over 100,000 btu:r—
wall/floor heatersF_—
Heat Pumps/Package Units
up to 100,000 btur—
up to 1,000,000 btuF—
up to 1, 750,000 btur—
> 1, 750,000 btu
Boilers/Compressors
up to 3 HPT-
3 HP-15 HPt
15 HP-30 HPr-
30 HP-50 HPF—
>50 HPf—
Air Handling Units
up to 10,000 CFM f —
> 10,000 CFMF—
VAV BoxF—
Repair/Alter/Add HVAC
Number of Zonesr—
Ventilation
Bathroom FanF—
Exhaust FanF—
Attic Exhaust
Residential Hood
Commercial HoodF—
Metal FireplaceF—
Gas Line
Fire DampersF—
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Electrical I Plumbing "'II
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F:r—
Multi Family S.F:r—
Receptacle, Switch Lighting Outlets
Total Outlets:r—
Lighting Fixtures
Total Fixtures:r—
Total Low Voltage
Separate Circuit
Motors/Transformers
Signs
0-1 HP or KVA: TS kVA
1-10 HP or KVAF-
10-50 HPorKVAr-
50-100 HP or KVA[__
Over 100 HP or KVA:r—
One branch circuit)—
Add'I branch circuit)
Service
0-600V not over 200A:r-
0-600V & over 200AF—
over 600VF—
Temp PP/Piggy Back:r—
Sub Panel:r—
Other
Water closet (toilet)F--
Bidet F_
Urinal F_
Bath TubF—
Shower stall
Lavatory (basin)F--
Hydro-massage tubt-
Kitchen
Kitchen sink
Garbage Disposalf—
Bar sinkr—
Vegetable sinkf—
Dishwasher
Laundry/washing trap
Ice maker
Floor smkF—
Miscellaneous
Floor drain) —
Water pipingF—
Water softenerF—
Water heatert—
Lavatory (basin)
Gas sys up to 4 outlets:r—
Gas sys # of outlets over 4t
13'3(10,
Backflow device up to 2 f _
BackFlow device over 2"1__
Regulators
Lawn Sprinkler System:r—
Roof drains f
Hose bibbF—
Drinking fountain
Greasetrap
Grease interceptor
P-trap[
Sewer
New sewerF—
Sewer alter/repair
Sewer abandonment
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