HomeMy WebLinkAboutXR2022-2367 - Permit ApplicationL Pnnt Form__ Worksheet for Combo Building & Solar Permit Application
(— Comm I r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME of suaMiTTni (1
7Building r Grading F—Drainage F_Elec r Mech l' Plum Cu vd cut Cu Yd Fill s
Project Address (Not mailing address) F— Flood F Fire F_ Liq F_ Landslide f N/A Floor Suite No
t�,, L " 12cF �— F_
Description of Work 0992,12
Use s ConstTypePsi s
# Stories # Units (if Res)
Valuation $ � .
Material/Labor
New/AddSF�v RemodelSF�— Garage/New/Add—
OWNER'S NAME Last First
Owner's Address Owner's E-mail Address
City r ! r_ __i611 State Zip 1�=� Telephone
APPLICANT'S NAME Last' Lr First
Applicant's Address Applicant's E-mail Address
/� c•l l/SE!! % / �7r�1%C'Iv GC/u�.�%��'c 1tC/v � C N,�IL � C('
City LC21/J %T< State �— zip F"&-t75" Tele hone
P 7/1/���
ARCHITECT/DESIGNER'S NAME Last Zj7� First
.lTH/—!! 6 V Lic. No s--
/
Architect/Designer's Address Architect/Designer's E-mail Address
_ , J City �Q/ J� State ��W� ZjP � ((y Telephone
ENGINEER'S NAME Last IF�09V5,E:S First %��(-,� Lic. No.
Engineer's Address Engineer's E-mail Address
City ! ,DNA State I ✓ IP . 9170/ Telephone T4 1 �! 5 20C-z'�
CONTRACTOR'S NAME/COMPANY nG,�f(/�?�FC/`j : / Lic. No. �?
a1lvz f �NL v 1T Class
o or c 's E-mail Address
Contractor's Addr/e[ss(/
/ r %
7&PI C 1
City L rf% ��r j� State � Zip '7 4:6 2� Telephone -7/1 c.
SETBACKS REAR SETBACKS FRONT ER VITT NO. j a
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK N .f "
USE ZONE DEVELOPMENT NOPLAN CHECK FEES $
Print Form Worksheet for Electrical/Mechanical/ Plumbing Application ?EWPot
a
City of Newport Beach
Building Division /� a
1. Project Address (Not mailing address) Building Permit No.
6001 IS'wFAIy, h- _ Floor Suite
[- 2.Owner's Name Last First
Owner's Street Address
6�0. _ j&Ll:; 1J 1 `-l-`L� _. City i rti r P,> State F(:5/- Zip r 1
Telephone F Owner's E-mail Address
r- 3. Applicant's Name Last P/�'P101{ _ _ _ First
Applicant's g�,Street Address
� f� fw. q'� s,.,t �C /�,
f W i _._. T/%4`.1.I T-I V I�. c _ _.. - _ CiTy w.7 X- 1 1 +-✓/date � ZiP _.
Telephone 1/f L"-i 1 2rpplicant's E-mail Address
4. Contractor's Name Last P� 1 J vI First D� State Lic #FE I aj�
Contractor's Street Address
l S2)1 _ PIT[ P)Z�_ city 20.71- J EE� State f � Zip 16[OL
Telephone—Zqe(_Qttractors E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btuF—
over 100,000 btuF—
wall/floor heatersF—
Heat Pumps/Package Units
up to 100,000 btuF—
up to 1,000,000 btu:f
up to 1, 750,000 btu!
> 1, 750,000 btuF-
Boilers/Compressors
up to 3 HPf-
3 HP-15 HPF-
15 HP-30 HPf --
30 HP-50 HPf_
>50 HPf_
Air Handling Units
up to 10,000 CFMt
> 10,000 CFMF-7
VAV Boxt
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fanf—
Exhaust Fan:_
Attic Exhaust
Residential Hoodf—
Commercial Hood
Metal Fireplace:f _
Gas Line:f
FireDampersf—
Electrical
New Construction Quantity
1 & 2 Family S.F:f —
Multi Family S.FF—
Receptacle, Switch Lighting Outlets
Total Outlets:f —
Lighting Fixtures
Total Fixtures
Total Low Voltage
Separate Circuit
Motors/Transformers
0-1 HP or KVA:f —
1-10 HP or KVAI
10-50 HP or KVAI
50-100 HP or KVAF—
Over 100 HP or KVA:F—
Signs
One branch circuit
Add'I branch circuit:f —
Service
0-600V not over 200A.F-
0-600V & over 200A1
over 600V:f
Temp PP/Piggy Back:f -T-
Sub Panel
Other
t 1 fp'"' 0 cxn-1 Plumbing
Bathroom Quantity Quantity
Water closet (toi let)f—
Bidet
Urinal
Bath TubF_-
Shower stallF_-
Lavatory (basin)F—
Hydro-massage tubFi
Kitchen
Kitchen sink
Garbage Disposal
Bar sink
Vegetable sink
Dishwasherf —
Laundry/washing trapf—
Ice maker
Floor sink
Miscellaneous
Floor drain
Water pipingF-
Water softener
Water heater
Lavatory (basin)F—
Gas sys up to 4 outlets!
Gas sys # of outlets over 4t-
Backflow device up to Z"F_-
Backflow device over 2" i
Regulators!
Lawn Sprinkler System:f —
Roof drains
Hose bibbl—
Drinking fountainr-
Grease trap
Grease interceptor
P-trap[
Sewer
New sewer
Sewer alter/repair
Sewer abandonment