HomeMy WebLinkAboutE2022-0637 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division s
1. Project Address (Not mailing address) Building Permit No.
COG hl evjf,A- e4e� pr:ae. SUS. 7G 706.. Floor j� Suite
1 2. Owner's Name Last First
Owner's Street Address
cityState F Zip
Telephone I Owner's E-mail Address I
Ijr 3. Applicant's Name Last First�p
CiTy e, t4- n _ State I ?47 Zip 3Z__' SFtAl_
phone _ `//y-zl S'_753`L Applicant's E-mail Address -k- IULQWO &sFnSCO + i,cM1
4. Contractor's Name Last L_ - First - State Lic #
tractor's Street Address
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btul
wall/floor heaters
Heat Pumps/Package Units
up to 100,000 btu:
up to 1,000,000 btu:
up to 1, 750,000 btu:
> 1, 750,000 btur
Boilers/Compressors
up to 3HP:
3 HIP-1 5 HPI
15 HP-30 HP:
30 HP-50 HP:
>50 HP:
Air Handling Units
up to 10,000 CFM:
> 10,000 CFMF7—
VAV Box
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fan:
Exhaust Fan F—
Attic Exhaust
Residential HoodT—
Commercial Hood
Metal Fireplace:r—
Gas Line::
Fire Dampers]
CiTy State C Zip
Contractor's E-mail Address
Electrical
New Construction Quantity
1 & 2 Family S.F::'
Multi Family S.F::
Receptacle, Switch Lighting Outlets
Total Outlets:;
Lighting Fixtures
Total Fixtures)
Total Low Voltage:r
Separate Circuit
Motors/Transformers
0-1 HP or KVA:
1-10 HP or KVA:
10-50 I-P or KVA)
50-100 HP or KVA:.
Over 100 HP or KVA:
Signs
One branch circuit:
Add'] branch circuit::
Service
0-600V not over 200A:
0-600V & over 200A:
over 600V::
Temp PP/Piggy Back:
Sub Panel:
Other::
Business Lic#
Bathroom Quantity Plumbing Quantity
Water closet(toilet): BackFlow device up to P':
Bidet Backflow device over 2"F
Urinal F____ Regulators[ ---
Bath Tub: Lawn Sprinkler Systeml
Shower stall Roof drains
Lavatory(basin): Hose bibbl
Hydro -massage tub) Drinkingfountainr--
Kitchen
Kitchen sink
Garbage Disposal
Bar sink
Vegetable sink
Dishwashe)
Laundry/washing trap
Ice maker
Floor sink
Miscellaneous
Floor drain
Water piping
Water softenerC—
Water heater
Lavatory (basin)
Gas sys up to 4 outlets:
Gas sys # of outlets over 4F—
Grease trap:-
Grease interceptor
P-trapl
Sewer
New sewer
Sewer alter/repair
Sewer abandonment