HomeMy WebLinkAboutH2022-0501 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical/ Plumbing Application
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City of Newport Beach
Building Division
1. Project Address (Not mailing address)BuildingBuilding Permit No. r•
!-1 Z%j YC SCQ /t/L J v _ _ _ _ _ Floor �— Suite
r 2. Owner's Name Last I ,, First
Owner's Street Address r� /,,
_�Zu�Z—__.�CsC0_� __.__ ._—_ ._ City _a��_._ .> _ _ _ State Zip _9
Telephone Z,5(On(o Owner's E-mail Address Y, o,_:t I. Cot%,L
r 3. Applicant's Name Last First�Wte�✓
App Iicant's Street Address
City
Telephone 9 Ct--f5_i $T-7�p Applicant's E-mail Address
State : Zip
4. Contractor's Name Last _ _ _ _ First <� V,L� _ State Lic#
Contractor's Street Address
City State : Zip
Telephone Contractor's E-mail Address Business Lic#
Mechanical
Furnace Quantity
up to 100,000 btul
over 100,000 btu:—
wall/floor heaters
Heat Pumps/Package Units
up to 100,000 btu: —
up to 1,000,000 btu: —
up to 1, 750,000 btu:—
> 1, 750,000 btul—
Boilers/Compressors
up to 3 HP:-
3 HP-15 HPs7
15 HP-30 HPf —
30 HP-50 HP:—
>50 HP: —
Air Handling Units
up to 10,000 CFM:—
>10,000CFMf —
VAV BoxT
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fan: —
Exhaust Fan: —
Attic Exhaust
Residential Hood
Commercial Hood: —
Metal Fireplace: —
Gas Line
Fire Dampers
Electrical
New Construction Quantity
1 & 2 Family S.F:I.
Multi Family S.F:,
Receptacle, Switch Lighting Outlets
Total Outlets::
Lighting Fixtures
Total Fixtures
Total Low Voltage,
Separate Circuit
Motors/Transformers
0-1 HP or KVAI
1-10 HP or KVAs
10-50 HP or KVA:
50-100 HPor KVA:
Over 100 HP or KVA:
Signs
One branch circuit
Add'I branch circuit:
Service
0-600V not over 200A1
0-600V & over 200A:
over 600V:
Temp PP/Piggy Back
Sub Panel:
Other:
Bathroom Quantity Plumbing Quantity
Water closet (toilet):
Bidet
Urinal s
Bath Tubl
Shower stall
Lavatory (basin)
Hydro -massage tubs
Kitchen
Kitchen sink s
Garbage Disposal:
Barsink:
Vegetable sink
Dishwasher
Laundry/washing traps
Ice makers
Floor sinks
Miscellaneous
Floor drains
Water pipings
Water softeners
Water heaters
Lavatory (basin):
Gas sys up to 4 outlets:
Gas sys # of outlets over 4:
Backflow device up to 2":
Backflow device over 2"F_
Regulators
Lawn Sprinkler System
Roof drains
Hose bibb:
Drinking fountain
Grease trapl
Grease interceptor
P-traps
Sewer
New sewer:
Sewer alter/repair
Sewer abandonments