HomeMy WebLinkAboutX2021-0583 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application
Print Form City of Newport Beach
Building Division
I. Project Address (Not mailing address) Building Permit No.
Clemente Drive
__.. Floor r3--- Suite 300
2. owner's Name Last St. Clair _
_.. First Cornelius
Owner's Street Address
City Weehawken
State NJ Zip 086
1177000 Harbor Boulevard, 9th Floor
Telephone 484.995.9334 Owner's E-mail Address
cornelmsstclair@ubs.com
_.
F_ 3. Applicant's Name Last Dias
_ __. First Clifford_..
A licant's Street Address
State NY Zip 11201.. -.
City Brooklyn
1 Main Street
_.
-.
Telephone 212.608.4811 Applicant's E-mail Address
Clifford@diaseng.com
r 4. Contractors Name Last TBD
„_. First
State Lic # �—
Contractor's Street Address
City F—_,
State F_. ZIP
Telephone
Mechanical
Furnace Quantity
up to 100,000 btu:—',.
over 100,000 boo :r—
wall/floor heaters:—'
Heat Pumps/Package Units
up to 100,000 btu f
up to 1,000,000 btu.
up to 1, 750,000 btu—'
> 1, 750,000 btu:F—'..
Boilers/Compressors
up to 3 HP:r—:
3 HP15 HP.1
15 HP-30 Hif
30 HP-50 HPF
>50 HPF_
Air Handling Units
up to 10,000 CFMF_
> 10,000 CFMF_
VAV Box
Repair/Alter/Add HVAC
Number of Zones:Fl
Ventilation
Bathroom Fan:F—
Exhaust Fan
Attic Exhaust:
Residential Hood
Commercial Hood:
Metal Fireplace:r—
Gas Line:F—
Fire Dampers:
Contractor's E-mail Address
Business Lic#
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.FF
Multi Family S.FJ
Receptacle, Switch Lighting Outlets
Total Outlets 14
Lighting Fixtures
Total Fixtures:r
Total Low Voltage :F—
Separate Circuitr—
Motors/Transformers
Signs
0-1 HP or KVA:
1-10 HP or KVA:r-
10-50 HP or KVA:F_
50-100 HP or KVAF_
Over 100 HP or KVAI
One branch circuit:r—.
Add'I branch circuit:f—
Service
0-600V not over 200A.1
0-600V & over 200A:—
over 600Vi
Temp PP/Piggy Back
Sub Panel:
Oth4_
Water closet (toilet):
Bidet
Urinal
Bath Tubr,
Shower stall:_
Lavatory(basin):
Hydro -massage tub:
Kitchen
Kitchen sink
Garbage Disposal:r
Bar sink
Vegetable sinks
Dishwasher.
Laundry/washing trap
Ice maker.F_
Floor sink:F_
Miscellaneous
Floor drain:
Water piping:
Water softener
Water heated
Lavatory (basin)r
Gas sys up to 4 outlets:F_
Gas sys # of outlets over 4r
Backflow device up to 2"k—
Backflow device over 2"F—
Regulator5:F—
Lawn Sprinkler System:
Roof drainsr
Hose bibb:r-
Drinking fountain:F_
Grease trap:F_
Grease interceptor.F_
P-trap:F—
Sewer
New sewer:F_
Sewer alter/repair:
Sewer abandonment
Print Form Worksheet for Combo Building & Solar Permit Application 1e
/t EWPo
C Comm'I City of Newport Beach - Building Division o
R F Residential
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding r—Grading F Drainage FX_Elec rX—Mech rPlum cuvdCut cuvdFill
�
Project Address (Not mailing address) F_ Flood r Liq r Landslide I —N/A Floor Suite No
888 San Clemente Dr., Newport Beach, CA 'Z � I' N/A
of Work
interior office renovation to existing office space, as per plans.
Use Const Type 11B
# Stories # Units (if Res)F
Valuation 5 0
New/Add SF10 Remodel SF 864 Garage/New/Add Material/Cabo '
OWNER'S NAME Last St. Clair First Cornelius
Owner's Address Owner's E-mail Address
1000 Harbor Blvd, 9th FI cornelius.stclair@ubs.com
City Weehawken State NJ Zip 07086 Telephone 484-995-9334
APPLICANT'S NAME Last I Hawks
Applicant's Address
555 W. 5th St. 35th Floor
City Los Angles State CA
First
Applicant's E-mail Address
ijessica@mccormickpermits.com
Zip 90013 Telephone 312-599-0267
ARCHITECT/DESIGNER'S NAME Last Horan First Ja
Y Lic. No. C18452
Architect/Designees Address
10921 Coronel Rd.
City Santa Ana State CA
Architect/Designer's E-mail Address
jayhoran@cox.net
Zip 92705 Telephone 940-510-8616
ENGINEER'S NAME Last Dias First Clifford Lic. No. M-23408
Engineer's Address Engineers E-mail Address
1 Main Street Clifford@diaseng.com
City Brooklyn State NY Zip 11201 Telephone 212-608-4811
CONTRACTOR'S NAME/COMPANYIz;WL
Olt S0// / � C7h am Lic No. /� Si/3 Class j
Contractor's Address / !G` Contracttoes E-mail Ad ss
l� mil Lri.Aj�r lce// G�yS�/rGl� I .to,
City Sy/�� State Zip ! Z Telephone.'(.
SETBACKS REAR SETBACKS FRONT PERMIT NO. X 0 dJt?aj
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $