HomeMy WebLinkAboutX2018-2534 - Permit Application2017-Z®18 X2010-1550
Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
to uv� LS s e � � ✓�? 2. c I— C lour
Suite
City State F71 Zip
Telephone Owner's E-mail Address
3. Applicant's Name Last First
A licant's Street Address
fEj! �71
__ _ ___ City �� State F7 Zip
Telephone 1 Applicant's E-mail Address _
F 4. Contractor's Name Last First _ State Lic# �—
Contractor's Street Address
City �------ 7 State F7_ Zip
Telephone Contractor's E-mail Address Business Lic# I l
Mechanical
Furnace Quantity
up to 100,000 btu:F ____ I
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 btu: 7
> 1, 750,000 btu:F-7
Boilers/Compressors
up to 3 HP:F-7
3 HP -15 HP:F_7
15 HP -30 HPF777
30 HP -50 HP:F_7
>50 HP::
Air Handling Units
up to 10,000 CFM::
> 10,000 CFM:[
VAV Box:
Repair/Alter/Add HVAC
Number of Zones:F__7
Ventilation
Bathroom Fan:
Exhaust Farr.
Attic Exhaust
Residential Hood::
Commercial Hood:[
Metal Fireplace:
Gas Liner
Fire Dampers
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F:F--7—
Multi Family S.RF-7
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total Fixtures:.77
Total Low Voltage:
Separate Circuit:
Motors/Transformers
0-1 HP or KVA:[-71
1-10 HP or KVA::
10-50 HPor KVA::
50-100 HPor KVA:
Over 100 HP or KVA:F---
Signs
One branch circuit:
Add'1 branch circuit:F__7
Service
0-600V not over 200A:1 3. 1
0-600V & over 200A::
over 600V:�
Temp PP/Piggy Back:
Sub Panel:
Other:
Water closet (toilet):
Bidet:n
Urinal :F7
Bath Tub:
Shower stall:F7
Lavatory (basin)::
Hydro -massage tub::
Kitchen
Kitchen sink:
Garbage DisposahC7
Bar sink:
Vegetable sink:
Dishwasher
Laundry/washing trap::
Ice maker::
Floorsink::
Miscellaneous
Floor drain:
Water piping:
Water softener.:
Water heater.:
Lavatory (basin):
Gas sys up to 4 outlets::
Gas sys # of outlets over 4::
Backflow device up to 2":
Backflow device over 2"F_�
Regulators
Lawn Sprinkler System::
Roof drains::
Hose bibb::
Drinking fountain::
Grease trap:
Grease interceptor::
P -trap:
Sewer
New sewer.
Sewer alter/repair:
Sewer abandonment::