HomeMy WebLinkAboutX2021-2038 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical/ Plumbing Application EWPoR,
City of Newport Beach
Building Division -
1. Project Address (Not mailing address) Building Permit No.
I r G-. / e, vim
.-_ _..._ ',,/Floor / Suite
F_ 2. Owner's Name Last --%0 y_�I- ( /, t>G. p'
OwnersStreetA dress - - First�a�v L/���
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Tate Zi
Telephone
Owner's E-mail
3. Applicant's Name Last Fiui
A licant's treet Address "�"�
Telephone 7/�i 7 �/,/).7..; ;)-Applicant's E-mail Address
4. Contractor's Name Last�,� �� a
Contractor's Street Address "
..... _ �3'U7/Y.�. (/t✓7_. //L 6_��C.. _. ___�I city
' State F— Zip F_�,
TelephoneContractor's E-mail Address 1I Business Lic # r'
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Mechanical
Furnace Quantity
up to 100,000 btu:—''.
over 100,000 btu:—',
wall/floor heaters:-.
Heat Pumps/Package Units
up to 100,000 btu:t—
up to 1,000,000 btu F_
up to 1, 750,000 btu•t;
> 1, 750,000 btu:
Boilers/Compressors
up to 3 HP:r
3 HP -15 HP;
15 HP -30 HPF —.
30 HP -50 HP.F_—'
>50 HIP :t -
Air Handling Units
up to 10,000 CFM[,
> 10,000 CFM:[
VAV Box:
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fan:F—
Exhaust Fare;
Attic Exhaust
Residential Hood.t-
Commercial Hood:'
Metal Fireplace[—,
Gas Line
Fire Dampersa
Electrical
New Construction Quantity
1 & 2 Family S.F.F_—'I
Multi Family S.FF7
Receptacle, Switch Lighting Outlets
Total Outlets:r—j
Lighting Fixtures
Total Fixtures:[
Total Low VoltageF-7
Separate Circuity -7
Motors/Transformers
0-1 HP or KVA;F—I
1-10 HP or KVAt�
10-50 HP or KVA:F_
50-100 HPor KVA:F--'.i
Over 100 HP or KVA:t,
Signs
One branch circuitF_
Add'I branch circuit:F77
Service
0-600V not over 200A:t-I
0-600V & over 200A:r
over 600V.�
Temp PP Piggy Back 1
Sub Paneh�-Ii
Other:
Bathroom Quantity Plumbing Quantity
Water closet (toilet)F7
Bidet _
Urinal :F71
Bath Tub:tj
Showerstall f -i
Lavatory(bash)a
"- i
Hydro -massage tub:—j
Kitchen
Kitchen sink:t,
Garbage DisposaCt1
Bar sink:F_
Vegetable sink:rt-
Dishwashertll
Laundry/washing trap:F_
Ice maker. -F --
Floor sink :F 1
Miscellaneous
Floordrairr.F_
Water piping:
Water softener.J-7
Water heater:[
J
Lavatory(basin) F-1
Gas sys up to 4 outlets 7'
Gas sys # of outlets over 4:t
Backflow, device up to 2"
Backflow device over 2":F
Regulators:,
Lawn Sprinkler System:—'
Roof drains :t
Hose bibbf__
Drinking fountain
GreasetrapF--
Greaseinterceptor:t
P-trapF—
Sewer
New sewer[—'.
Sewer alter/repair:
Sewer abandonment