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J r� `r `. awl �3 i, �i3 `f� - h4 h ��i.F'9!. t.M'tei,Mii k ��'£vm� •t" X �'s��.SP�T"�;iT � } i Cbd4 t I— �'3, lu' �4Zo1q oq 1 Z 1Gto F--cyv,\e--w G;v. CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 COMMERCIAL MECHANICAL, ELECTRICAL, AND PLUMBING QUESTIONNAIRE FOR PLAN REVIEW WAIVER Job Address: (GD_?Keyia-to C(RLLT The above -proposed project may require electrical, mechanical, and or plumbing plan checking. The following questions are regarding the new proposed work and the applicable areas it serves. If the answer to a question below is "YES," a plan check is required for the Electrical, Mechanical, and/or Plumbing portion of work. To expedite the permit process, please submit this questionnaire along with an application and three (3) sets of plans. NOTE: The Chief Building Official may make exceptions for minor work, additions, and alterations. COMMERCIAL TENANT IMPROVEMENTS ONLY GENERAL NO YES 1. Is the area of work more than 2,500 square feet? ❑ P" TT 2. Is the area of work for OTHER THAN an occupancy classification and E3 (use) of B (office), or M (retail)? 3. Does the area of work require a concurrent review from any other City E3department ar or outside agency (i.e. Health, Fire, or Public Works)? PLUMBING NO YES 4. Does the work include more than 9 plumbing fixtures? j9 ❑ 5. Is the potable water piping 2 -inches or greater? ❑ 6. Does the work involve the installation of any pumps? ❑ 7. Does the work include a gas system other than typical low pressure 0 ❑ system? 8. Are there any installations, alterations, or relocations of a grease ❑ interceptor and or clarifier? 9. Is the plumbing work above the ground floor in a high-rise building? Al ❑ MECHANICAL NO YES 10. Does the work include any refrigeration equipment? ❑ 11. Does the work include new rooftop equipment weighing a total of 250 lbs. ❑ or more? 12. Does the work include altering the existing smoke detection system in the OF ❑ air plenum? 13. Does the work include duct work with fire and or smoke dampers or duct PC ❑ extensions over 25 feet? 14. Are there any new installations containing a commercial type kitchen ®' ❑ hood, Types I or II? ELECTRICAL NO YES 15. Does the work include a new service, sub panel, or transformer rated ❑ over 400 amps? 16. Does the work involve more than 5 branch circuits? ❑ 17. Indoor lighting: Any new or replacement lighting over 50% of the existing ❑ lighting in the area? 18. Outdoor lighting: Any new or replacement lighting over 50% of the ❑ existing luminaries in a permitted area? 19. Does the work involve any high voltage installations (over 600 volts)? � ❑ ITEMS NOT ELIGIBLE FOR M.E.P. PLAN REVIEW WAIVER PLUMBING MECHANICAL ELECTRICAL • New restroom facilities • Septic tanks, cesspools • Chemical waste • Combination waste & vent • Boilers • Spray booth • Fire and/or smoke damper • Medical gas system • Medium pressure gas piping • OSHPD 3 uses • Dock or harbor power • Photovoltaic or standby generator • Fuel cells I certify that the above inf ation is true and correct. Signature: L Date: �o22/ZD! g Print Name: Phone #: Forms\COMMERCIAL MechanicalElecMcalPlumbingPlanCheckQuestionnaim 2