HomeMy WebLinkAboutH2023-0331 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application ozEW�,rm
( Comm'I Residential
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL ��„. ,.
Building r Grading rDrainage r Elec r Mech r Plum Cu vd cut Cu Yd Fill
Project Address (Not mailing address) I— Flood r Fire r Liq r— Landslide rN/A Floor Suite No
Description of Work
Use pup�cConstType V�p�
# StoriesF # Units (if Res
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New/Add SFF— Remodel SFF Gara a/New/Add F—
g
Valuation $ -71
Material/Labor ks Z
OWNER'S NAME Last
First
Owner's Address
�S 9w'.a �i t'i S r
b
F wner's E-mail Address
City . d�vIA-T �jr
State f R Zip s Telephone
APPLICANT'S NAME Last
First G7
Applicant's Address
Applicant's E-mail Address
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J.�✓tY �i�� /i vt�,; j �� � �5. ��,>'. w�i�'t
City �i h 4
State e� Zip 11 3 } Telephoned
ARCHITECT/DESIGNER'S E�SIGNER'S NAME
Last First F_
Lic. No.
Architect/Designer's Address
ArchitecttDesigner's E-mail Address
City
State F_ Zip F_ TelephoneF_
ENGINEER'S NAME Last
First F_ Lic. No.F
Engineers Address
Engineers E-mail Address
City I
State F— Zip � Telephoned
CONTRACTOR'S NAME/COMPANY
Lic. No. F ClassF—
Contractors Address
Contractors E-mail Address
City
State F— Zip �— Telephoned
tot 1- 6331
SETBACKS REAR
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SETBACKS FRONT PERMIT NO)0261•3i�//�20�
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO. Pc W . 1 t 47
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
Worksheet for Electrical/Mechanical/ Plumbing Application oYEW�Rm
City of Newport Beach
Building Division " a,
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1. Project Address (Not mailing address) Building Permit No. IH M3/011DW
ly
Floor F Suite F
2. Owner's Name Last - L[m - First
Owner's Street Address .y --- -- -- -- - - -----
,_f_ W D, i�✓� i 4-—__---- ��I�, State. zip 37
a _____ _ _ city h nc TTT��, ddd —
Telephone !I �D; V�ners E-mail Address ` �h
(— 3. Applicant's Name Last First t (^
Applicant's Street Address -
city state 6-
k zip oI Z S
---
Telephone Applicant's E-mail Address
C 4. Contractor's Name Last ( -1ke C-,, - State Lic#
r�4�Q_rn._�1 hl —
ntractor'sStreet Address ��,w
--_ -- ----Ste'-L'--_ 'r city _. f State FC;F� zip
Telephone Contractors E-mail Address
Business Lic#�L
Mechanical
Furnace Quantity
upto 100,000 btu17
over 100,000 btu. —I
wall/floor heaters:F77
Heat Pumps/Package Units
up to 100,000 btu: —
up to 1,000,000 btu::
up to 1, 750,000 btu::—
> 1, 750,000 btu:F—
Boilers/Compressors
up to 3 HP:F
3 HP-15 HP::-
15 HP-30HP:-
30 HP-50 HP f
>50 HP:7
Air Handling Units
up to 10,000 CFM::
>10,000 CFMT —
VAV Box:r—
RepairlAiter/Add HVAC
Number of Zones:
Ventilation
Bathroom Fan
Exhaust Fan::-
Attic Exhaust:
Residential Hood:r�'
Commercial Hood:r®
Metal Pireplacef--
Gas Line:r
Fire Dampers:-,
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantit
y
1 & 2 Family ST F—
Multi Family S.F:�
Receptacle, Switch Lighting Outlets
Total Outlets:rT7-
Lighting Fixtures
Total Fixtures
Total Low Voltag-T
Separate Circuit::
Motors/Transformers
0-1 HP or KVA:r
1-10 HP or KVA::
10-50 HP or KVA17�
50-100 HPor KVA:�
Over 100 HP or KVA:
Signs
.One branch circuit E7
AdcI1 branch circuit::-
Service I-- -----
0-600V not over 200A::0-
0-600V & over 200Ar
over 600V::�,
Temp PP/Piggy Back::
Sub Panel
:�—
Other.F—
Water closet (toilet)
Bidet:
Urinal::
Bath Tub:
Shower stallF7
Lavatory (basin):
Hydro -massage tub:
Kitchen
Kitchen sink:,
Garbage Disposal
Bar sink::
Vegetable sink
DishwasherC
Laundry/washing trap:
Ice maker.:
Floorsink.:
Miscellaneous
Floor drain:
Water piping::
Watersoftener:�
Water heater=
Lavatory (basin)::1
Gas sys up to 4 outlets::
Gas sys # of outlets over kF—
Backflow device up to 2":
BackBow device over 2'4:�;
Regulators:_
Lawn Sprinkler System::
Roof drains::
Hose bibb::
Drinking fountain f —
Grease trap::
Grease interceptor.'
P-trap:
Sewer
New sewer.—_
Sewer alter/repair:
Sewer abandonment::