HomeMy WebLinkAboutPV2022-0447 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application �EW�Rr
City of Newport Beach
Building Division
1. -__ - Project Address (Not mailing address) ,r� Building Permit No.
__0 0l- - T.._
w . _- _ _. _ -.- __ - _____.. - _..__- Floor �— Suite
2.Owner's Name Last _ �( First
Owner's Street Address --- ----- ----- _--- -- r---
City State Zip F_
Telephone Owners E-mail Address
F-I 3, Applicant's Name Last ,/) First L J411?
A licants Street Address - - - j�q'>�/
-_ C�-'__ City o State zip _1�QI I11�
Telephone Applicant's E-mail Address
F_ 4. Contractor's Name Last _ _1n0A4ia/ _ _ _ _ First State Lic #
Contractor's Street Address
___ ___ ___ ___- _ _ CiTy State FZip
Telephone F—Contractor's E-mail Address _ _ Business Lic#
Mechanical
Furnace Quantity
up to 100,000 btu::
over 100,000 btu:r
wall/floor heaters[ --
Heat Pumps/Package Units
up to I00,000 btu:
up to 1,000,000 btu:F
up to 1, 750,000 btu::—
> 1, 750,000 btu::—
Boilers/Compressors
up to 3 HP::
3 HP-15 HP1777
15 HP-30 HPF_
30 HP-50 HP:�
>50 HP177
Air Handling Units
up to 10,000 CFM[777
> 10,000 CFM:F_
VAN Box:F —
Repair/Alter/Add HVAC
Number of Zones:
Ventilation
Bathroom Fan
::-
ExhaustFan::-
Attic Exhaust
Residential Hood
Commercial Hood
Metal Fireplace::
Gas Line:: -
Fire Dampers:: —
Electrical
New Construction Quantity
1 & 2 Family SYF77
Multi Family SY F_
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total Fixtures::
Total Low Voltage:'
Separate Circuit:
Motors/Transformers
0-1 HP or KVA::j
1-10 HP or KVA:F'
10-50 HP or KVA:F----
50-100 HP or KVA:F_
Over 100 HP or KVA:1
Signs
One branch circuit :E—
Add'I branch circuit:F_
Service -------
0-600V not over 200A:F_
0-600V& over 20047
over 600V: ___
Temp PP/Piggy BackF77
Sub Panel:F—
Othereqq
M or I
Bathroom Quantity
Plumbing Quantity
Water closet(toilet)f__
Backflow device up to 2"1-7
Bidet::
Backflow device over 2"::—'
Urinal::
Regulators: —
Bath Tub:
Lawn Sprinkler System::�
Showerstall::
:--
Roof drains
Lavatory (basin):F —
Hose bibb::
Hydro -massage tub:— Drinking fountain :F—
Kitchen
Kitchen sink:?
Garbage DisposakC
Barsink:
Vegetable sink::
Dishwasher:
Laundry/washing trap:
Ice maker.:
Floor sink
Miscellaneous
Floor drain::
Water piping:
Water softener:
Water heater:
Lavatory(basin)::
Gas Sys up to 4 outlets::
Gas sys # of outlets over 4:F—
Grease trap:.
Grease interceptor:'
P-trap::
Sewer
New sewer.
Sewer alter/repair.:'
Sewer abandonment:��i
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