HomeMy WebLinkAboutE2022-0230 - Permit ApplicationPrint FormWorksheet for Electrical/Mechanical/ Plumbing Application
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f� GZ ,..o271 City of Newport Beach
G1Building Division I12�"2 G2�
1. Project Address (Not mailing address) Building Permit No. Z0zj-0T7f
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Floor Suite
u 2. Owner's Name Last S S S First
Owner's Street Addr ss
City f2 State ® Zip
Telephone Owner's E-mail Address
3. Applicant's Name Last 5-- e First
A litany, Street Address
city CQLe zia_.. state zip R r 7y O
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Telephone (� G1'�j�%(J(p 'Applicants E-mail Address s (�
<U NAvL1-c �t rr'\
l] 4. Contractor's Name Last First J State Lic #
Contractors Street Address
r () City (y CQN l,rA State Zip a ( Sf U
Telephone C( — U tContractors E-mail Address
Business Lic#
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btu:
wall/floor heaters
Heat Pumps/Package Units _
up to 100,000 btu:— i
up to 1,000,000 btu:
up to 1, 750,000 btu
> 1, 750,000 btu:
Boilers/Compressors
up to 3 HPF-7
3 HP-15 HPF1
15 HP-30 HP 7
30 HP-50 HP
>50 HP1
Air Handling Units
up to 10,000 CFMf--7
> 10,000 CFM:—.
VAV Box
Repair/Alter/Add HVAC
Number of Zones)?
Ventilation
Bathroom FareC
Exhaust Fan:C—�,
Attic Exhaust.
Residential Hood:C—I
Commercial Hood:�l
Metal Fireplace[ —
Gas Line—
Fire Dampers
Electrical I Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F.0
Multi Family S.FF--1
Receptacle, Switch Lighting Outlets
Total Outlets
Lighting Fixtures
Total Fixtures,
Total Low Voltage
Separate Circuit'.
Motors/Transformers
0-1 HP or KVA177.
1-10 HP or KVAf�
10-50 HP or KVA
50-100 HP or KVAF-1
Over 100 HP or KVAF--7j
Signs
One branch circuit
Add1 branch circuitE77
Service
0600V not over 200Af',
0-600V& over 200A:F777
over 600VF---7
Temp PP/Piggy BackF77ll
Sub Panel1:77
OtherlI
Water closet (toilet)
Bidet
Urinal 171
Bath Tub:
Showerstallr
Lavatory (basin)
Hydro -massage tubF7
Kitchen
Kitchen sink
Garbage Disposal
Bar sink
Vegetable sink
DishwasherC
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�
Backflow device up to 2"F7
Backflow device over 2"177
Regulators
Lawn Sprinkler System
Roof drains
Hose bibbr
Drinking fountain
Grease trap
Grease interceptor
P-trap)
Sewer
New sewer
Sewer alter/repair))
Sewer abandonment