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Home My WebLink AboutX2019-2424 - Permit ApplicationCam, G-1w, Itc Worksheet for Combo Building & Solar Permit Application W 7omm'I (` Residential City of Newport Beach - Building Division y 5f fop„" NOTE;,PLAN CHECK FEES DUE AT TIME OF SUBMITTAL �Nuilding F Grading (—Drainag jlec �MechPlu cuvdCut i-- CuYdFill � ttpmailing a ress) F_ Flood ire r Liq F_ Landslide FN/A Floor Suite No Address (Not Project Description of offfWo�rrkkk �� Use ConstType # Stories # Units (if Res) j��/ - y" ' �Up`-A" ` Caluatio a7 abor New/Add SF Remodel SF Garage/New/Add F_ OWNER'S NAME Last �Iddrsr Owner's Address Owner's E-mail C City State- Zip I Telephone® APPLICANT'S NAME Last I (ICJ / s First Applicant's Address Applicant's E-mail Address City State �_. Zip / LI Telephon tyvl ,t6vl 3 J "� L ARCHITECT/DESIGNER'S NAME Last F_ First IF Llic. No. Architect/Designers Address Architect/Designers E-mail Address City �— State �v Zip I Telephone ENGINEER'S NAME Last V "aW(s First j Lic.NoTo,(0� — Engineers Address Engineer's E-mail Address I City State�I Zip Telephone CONTRACTOR'S NAME/COMPANY ( Lic. No. r71Class;j gTj FJ Contractor's Ad ress Contracto�Address City I1 � State Zip LCl L J Telephonej��JUI _ BACKS REAR SETBACKS FRONT PERMIT NO. ET CKS LEFT SETBACKS RIGHT PLAN CHECK NO. IN DEVELOPMENT NO PLAN CHECK FEES $ Print Form Worksheet for Electrical/Mechanical/ Plumbing Application >m City of Newport Beach'oa,.S Building Division X-C)Uiz i - �J �:, U �9 o�E��R : 1. Project Address (Not mailing address) Building Permit No. 4301 Jamboree Rd. Floor F_ Suite r 2.Owner's Name Last First Owner's Street Address City F_ State r Zip F_ Telephone F_ Owner's E-mail Address F_ 3. Applicant's Name Last Zoscak First Lisa AD ol!cant's Street Address 32232 Paseo Adelanto, Ste A City San Juan Capistrano State CA Zip 92675 Telephone 949-493-9548 Applicant's E-mail Address lira@aquatictechnologies.mm 1- 4. Contractor's Name Last Aq a hnoogies First --_ State Lic# 744177 Contractor's Street Address 32232 Paseo Adelanto, Ste A City San Juan Capistrano State CA Zip 92675 Telephone 949-493 9548 Contractor's E-mail Address lisa@aquatictechnologies.com Business Lic# I - Mechanical Furnace Quantity up to 100,000 btu:r- over 100,000 btuf - wall/floor heatersl- Heat Pumps/Package Units up to 100,000 btul- up to 1,000,000 btui up to 1, 750,000 btuT— > 1, 750,000 btu:r— Boilers/Compressors up to 3 HPF-- 3 HP-15 HP.f 15 HP-30 HP[_ 30 HP-50 HPf— >50 HP:F— Air Handling Units up to 10,000 CFMf - > 10,000 CFMI- VAV BoxF_ Repair/Alter/Add HVAC Number of Zonesl- Ventilation Bathroom Fan Exhaust FanF— Attic Exhaust:r— Residential Hoodl- Commercial Hood.r- Metal FireplaceF— Gas LineF - Fire DampersF— Electrical New Construction Quantity 1 & 2 Family S.FF— Multi Family S.FF_ Receptacle, Switch Lighting Outlets Total Outlets:0-,7- Lighting Fixtures Total Fixtures. Total Low Voltage Separate Circuitf- Motors/Transformers 0-1 HP or KVAfF3_ 1-10 HP or KVA:r- 10-50 HP or KVAI 50-100 HP or KVA:r— Over 100 HP or KVAT— Signs One branch circuit[-- Add'I branch circuitF- Service 0-600V not over 200AT_ 0-600V & over 200AF- over 600V:r— Temp PP/Piggy Back:r Sub PanelF_ Bathroom Quantity Water closet (toilet) — Bidet Urinal �— Bath Tubl Shower stalIf— Lavatory (basin):r Plumbing Quantity Backflow, device up to 2"I Backflow device over 2"I Regulators) Lawn Sprinkler System/ Roof drains/ Hose bibbl Hydro -massage tubr Drinking fountain F- Kitchen Kitchen sink �- Garbage Disposal Bar sink Vegetable sinkf— Dishwasher Laundry/washing trap:r Ice makerr Floor sink/ Miscellaneous Floordrainf— Water piping/ Water softener) Water heater/ Lavatory(basin)r Gas Sys up to 4 outlets/ 4l Grease trapF- Greaseinterceptorl P-trap Sewer New sewer/ Sewer alter/repair/ Sewer abandonment:r 4Jz(G)OU V7LlD- zo1 XZU1�l _2�� 4_L8S 76 Gas Sys # of outlets over . - 0�3 �I �7