HomeMy WebLinkAboutH2021-0502 - Permit ApplicationPrint Form
Worksheet for Electrical/Mechanical/ Plumbing Application 16WPOyT
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City of Newport Beach I n
Building Division �J� 4 oawr
1. Project Address (Not mailing address) Building Permit No. yy .,4 " q / / ti '.. J
Floor Suite
`-�! �_'
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r 2. Owner's ` P Last. _ •�- City State : Zip Firs[ ti —
Owner's Street Address
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Telephone i yG1 �(`;U/ Owner's E-mail Address _
r 3.ApplicanVs Name Last _. r , f _I First Y
A Ill's Street Address 4 /
--_-- _ City State
_5 e— r'01. Zip
Telephone Fi Applicant's E-mail Address _
4. Contractor's Name Last First State Lic#
Contractors Street Address
1164-1 City
Telephone ! Contractor's E-mail Address //I is ,
Mechanical
Furnace III���QuQuantity
anti
up to 100,000 btua '�y
over 100,000 btu: +
wall/floor heaters:,
Heat Pumps/Package Units
up to 100,000 btu:
up to 1,000,000 btu:F—':
up to 1, 750,000 btu:F_
> 1, 750,000 btu:��,
Boilers/Compressors
up to 3 HP:F__
3 HP 15 HP.F--,,
15 HP-30 HPF_
30 HP-50 HP:F
>50 HP:F_
Air Handling Units
up to 10,000 CFMF__
> 10,000 CFM:
VAV Box;
Repair/Alter/Add HVAC
Number of Zones:
Ventilation
Bathroom Fan:
Exhaust FareF—
Attic Exhaust:—'
Residential Hood:'_
Commercial Hood:F—',
Metal Fireplace:r
Gas Liner
Fire Dampers:F_
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:—IJ
Separate Circuit[77i1
Motors/Transformers
0-1 HP or KVAF-7
i-10 HP or KVA:F--
10-50 HP or KVA:F'
50-100 HP or KVA:
Over 100 HP or KVA:_
Signs
One branch circuit:
Add'I branch clrcuit:l 1
Service
0-600V not over 200A:—I
0-600V & over 200A:F—I
over 600V.-F77
Temp PP/Piggy. Back:'
Sub Pane f
Other:
rn�u eh 4JState 6F Zip To.-...I'
.V . -, Business Lic # F i
Bathroom Quantity Plumbing Quantity
Water closet(toilet).F�7 Backflow device up to 2".�—
Bidet: : Backflow device over Z".�!,
Urinal:F77 Regulators:_
Bath Tub:F; Lawn Sprinkler System
Showerstall f—, Roof drains:
Lavatory (basin):—; Hose bibbF_
Hydro -massage tub F77 Drinking fountain—'.
Kitchen Grease trap:
Kitchen sink r
Grease in[erceptorF—.
Garbage Disposal r—'I
P-trap:
Bar sink: � Sewer
q � New sewer::
Vegetable sink:
Dishwasher— Sewer alter/repair:F
Laundry/washing trap:a1 Sewer abandonment:
Ice maker.F-I
Floor sink
Miscellaneous
Floor drain:F__
Water piping:��i
Water softener:�_'
Water heater:
Lavatory (basin):'
Gas sys up to 4 outlets:Fl.
Gas sys # of outlets over 4:F-
4