HomeMy WebLinkAboutH2021-0566 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach � 059.Z_zot4
Building Division
1. Project Address (Not mailing address) Building Permit No. �—
_r
F_ 2.Owner's Name Last 5�-
OwnersStreet Address -- -
City
Telephone
Owner's E-mail Address
-. Floor Suite F—
First
State Zip
3.Applicant's Name Last First
A licant's Street Address - - - ._
- _ city� State Zip F - - - - - - --
Telephone �— Applicant's E-mail Address
4. Contractor's Name Last Qf /J ir1,Lf-!Ae/ First _ _ _. _ --
Contractor's Street Address
�( cS%%% 7 .-vim- State Lic# r
�,--cu1w� �- ��ontractor's E-mail Address -' City c � ��_� � Zip ��'-_
Telephone 1 t 6 `'77 _
BLLsiness Lic # _ _- _ _ _ _ _ J
Mechanical
Furnace Quantity
up to 100,000 btu::
over 100,000 btu::
wall/Floor heaters::
Heat Pumps/Package Units
up to 100,000 btu: —
up to 1,000,000 btu.F:
up to 1, 750,000 btu:
> 1, 750,000 btu::
Boilers/Compressors
up to 3 HP::
3 HP-15 HP:
15 HP-30 HPr�
30 HP-50 HP:—
>50 HP:�
Air Handling Units
up to 10,000 CFMF_
> 10,000 CFMF—
VAV Box:r—
Repair/Alter/Add HVAC
Number of Zones:I—
Ventilation
Bathroom Fan::_
Exhaust Fan:: —
Attic Exhaustr—
Residential Hood:r—
Commercial Hood::
Metal Fireplace::
Gas Line r—
Fire Dampers:F—
Electrical
New Construction Quantity
1 & 2 Family S.F:
Multi Family S.F.0
Receptacle, Switch Lighting Outlets
Total Outletsf—
Lighting Fixtures
Total Fixtures:_ —
Total Low Voltage,
Separate Circuit—'
Motors/Transformers
0-1 HP or KVA:_
1-10 HP or KVA:F-
10-50 HP or KVA:r-
50-100 HP or KVA:r
Over 100 HPorKVA::-
Signs
One branch circuit::-
Add'I branch circuit:F—
Service
0-600V not over 200Af
0-600V& over 200AF--
over 600V:--
Temp PP/Piggy Back::_
Sub Panel :r—
Othern—
Bathroom Quantity
Plumbing
Quantity
Water closet (toilet)
BackBow device up to 2"r
Bidet:
BackBow device over
Urinal :F--
Regulators:
Bath Tub:
Lawn Sprinkler System:
Showerstalb:
Roofdrains.:
Lavatory (basin):
Hose bibbF_
Hydro -massage tub: Drinking fountain:
Kitchen
Kitchen sink
Garbage Disposal
Barsink:
Vegetable sink
Dishwasher
Laundry/washing trap:
Ice maker:
Floorsink:
Miscellaneous
Floor dmirr::
Water piping:F_
Water softener:
Water heater:
Lavatory (basin):
Gas sys up to 4 outlets:
Gas sys # of outlets over 4::
Grease trap:
Grease interceptor.:
P-trap::-
Sewer
Newsewerr
Sewer alter/repair.V
Sewerabandonment: