HomeMy WebLinkAboutH2022-0355 - Permit Application— Worksheet for Electrical/Mechanical/ Plumbing Application
Print Form City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.[ 20Z7—. o�
'�/_ Ile, �` 5 errs e�IyL 4 Floor F_ Suite
2.Owner's Name Last First
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Owner's Street Address l D j%...
City State F Zip
Telephone z Owner's E-mail Address
r, 3. Applicant's Name Last //,hf' First ,wi/�j
Applicant's Street Address
City V,///7�i�1�% �./�ti�=�i State G'ifi Zip /�lv
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C'0<IFORR�r
Telephone q� J�% 'I jJV Applicant's E-mail Address
4. Contractor's Name Last ff�� �1/ gSjJ- State Lic #
L�1���!?i -- -_ _ _ First �--------- --- i
Contractor's Street Address —
Telephone fr� ^1�� �6� Contractor's E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btu:!
over 100,000 btu:�—
wall/floor heaters.
Heat Pumps/Package Units
up to 100,000 btuF—
up to 1,000,000 btuF�
up to 1, 750,000 btu
—
> 1, 750,000 btu:��
Boilers/Compressors
up to 3 HP
3 HP-15 HPf_
15 HP-30 HPF_
30 HP-50 HPF_
>50 HP�
Air Handling Units
up to 10,000 CFM:
> 10,000 CFM:�w
VAV Box-T
Repair/Alter/Add HVAC
Number of Zones.
Ventilation
Bathroom Fan:Fr
Exhaust Fan:
Attic Exhaust:
Residential Hood-F.-
Commercial Hood:
Metal Fireplace:_
Gas Liner
Fire Dampers:F_
- Electrical
New Construction Quantity
1 & 2 Family S.F�
Multi Family S.Fe_
Receptacle, Switch Lighting Outlets
Total Outlets
Lighting Fixtures
Total Fixturesir
Total Low Voltage!
Separate Circuit:��
Motors/Transformers
0-1 HP or KVA:��
1 -10 HP or KVAf_
10-50 HP or KVAf-
50-100 HP or KVAT�
Over 100 HP or KVA:1 __�
Signs
One branch circuit]
Add'I branch circuit:F
Service
0-60OV not over 2004
0-600V & over 200A:�r
over 60OV-F
Temp PP/Piggy Back:
Sub Panel-F.
Other-F
City-�JJGIl/� ���f�G State W Zip �{
C6'/t�'7 Business Lic #
Bathroom Quantity Plumbing Quantity
Water closet (toilet)e77
Bidet
Urinal T�I
Bath Tubf-----
Shower stall
Lavatory (basin);
Hydro -massage tub. J
Kitchen
Kitchen sink l '
Garbage Disposal—7
Bar sink I
Vegetable sink
Dishwashef�
J
Laundry/washing trap:
Ice makerF---'
Floor sinkf--7
Miscellaneous
Floor drain:_
Water piping
Water softenerF77
Water heater:
Lavatory (basin):
Gas sys up to 4 outletsT7
Gas sys # of outlets over 4:F
Backflow device up to 2"_
Backflow device over 2"
Regulators
Lawn Sprinkler System
Roof drains
Hose bibb[__
Drinking fountain
Grease trap
Grease interceptor
P-trapF
Sewer
New sewer
Sewer alter/repair
Sewer abandonment