HomeMy WebLinkAboutH2022-0483 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application
Print Form o 0
— - City of Newport Beach U •. �
Building Division a.
1. Project Address (Not mailing address) Building Permit No.
)_O O 2 1�4_ M_ ,LO`"'t V�/ Floor F_— Suite I
r 2. Owner's Name Last_ First 7FTGt-4
Owner's � Street Address
21 L 2Yf/..�Kr±� t! _ _. _. City State Zip i"I LrYlf/V.
Telephone I �21 Owners E-mail Address
r73. Applicant's Name Last First
A licant's Street Address
_Z--.-�---- --------- --- -. .__..__-- City__�`_'_t_ State Zip
Telephone i7 Z o Applicant's E-mail Address
4.Contractor's Name Last _ (, _ - - -- _ First _ _ TvLL_ -- State Lic# Tr1TZ
Contractors Street Address
City State R. Zip fr_
Telephone&�'L Ni`�7L)t Contractors E-mail Address <.( usiness Lic# gi
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btu)
wall/Floor heaters
Heat Pumps/Package Units
up to 100,000 btuF—
upto 1,000,000 btu:
up to 1, 750,000 btu
> 1, 750,000 btu)
Boilers/Compressors
up to 3 HPF_—
3 HP-15 HP::
15 HP-30 HP:-
30 HP-50 HP:
>50 HPf—
Air Handling Units
up to 10,000 CFM:
> 10,000 CFM:
VAV Box)
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fan F—
Exhaust Fan:
Attic Exhaust
Residential Hood) —
Commercial Hood
Metal Fireplace
Gas Line
Fire Dampersr—
Electrical I Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F:
Multi Family S.F:
Receptacle, Switch Lighting Outlets
Total Outlets.F_
Lighting Fixtures
Total Fixtures
Total Low Voltage
Separate Circuit
MotGrs/Transformers
0-1 HP or KV477
1-10 HP or KVA:
10-50 HP or KVA:
50-100 HP or KVA:
Over 100 HP or KVAF—
Signs
One branch circuitF—
Add'I branch circuit:
Service
0-600V not over 2004 —
0-600V & over 2004—
over 600V::
Temp PP/Piggy Back:
Sub Panel::
Other
Water closet (toilet)
Bidet C
Urinal:
Bath Tub:
Shower stall:
Lavatory (basin):
Hydro -massage tub:
Kitchen
Kitchen sink:
Garbage Disposal:
Bar sink:
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:
Backflow device up to 2"::
Backflow device over 2":
Regulators
Lawn Sprinkler System:
Roof drains:
Hose bibb:
Drinking fountain:
Greasetrap:
Grease interceptor:
P-trap:
Sewer
New sewer:
Sewer alter/repair:
Sewer abandonment: