HomeMy WebLinkAboutX2022-1603 - Permit Application (3)Print Form Worksheet for Electrical/Mechanical/ Plumbing Application t
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1. Project address NCity of Newport Beach
Building Division
1 (Not mailing address) Building Permit No.
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Floor Suite
r 2.Owner's Name Last I Y0qW\i\CAA First I MQ*\VVJ
Owner's Street Address -
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Telephone �^ L\V'Y) -split, Owner's E-mail Address _: LpgV LrJ J t Ar\ ei Vh a% . eon
I 3.Applicant's Name Last I GV\O\/\CM _ First M_ -.
Applicant's Street Address
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Telephone gV A�1J\tpryl..Applicant's E-mail Address Yh\,poP(1,OV %(,\*I e, ohM CO V✓1
4.Contractor's Name Last Cvu ") First Lois ' State Lic# /Or F,5?6
Contractors Street Address � /'Ke State
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1S '2C000. rcfser! G LA
City A ' Zip zJ3 �
Telephone FP/ L/o vjZJ Contractor's E-mail Address LQC/anJsGfelnc l7Lp�BUM1siness Lic# �1U®7$5/s
Mechanical
Furnace Quantity
up to 100,000 btu
over 100,000 btul
wall/floor heaters
Heat Pumps/Package Units
up to 100,000 btuF
up to 1,000,000 btul
up to 1, 750,000 btul
> 1, 750,000 btu
Boilers/Compressors
up to 3 HPI
3 HP-15 HPF
15 HP-30 HP`-
30 HP-50 HPF--
>50 HPI—
Air Handling Units
up to 10,000 CFM1—
> 10,000 CFMF—
VAV BoxF__
Repair/Alter/Add HVAC
Number ofZonesl-
Ventilation
Bathroom Fanl
Exhaust Fanl
Attic Exhaust
Residential Hood
Commercial Hood
Metal Fireplace
Gas Line
Fire DampersF_—
Electrical
New Construction Quantity
1 & 2 Family S.FI
Multi Family S.FI
Receptacle, Switch Lighting Outlets
Total Outletsl
Lighting Fixtures
Total Fixtures
Total Low Voltage
Separate Circuit
Motors/Transformers
0-1 HP or KVAI
1-10 HP or KVAI
10-50 HP or KVAr
50-100 HP or KVAI
Over 100 HP or KVAI
Signs
One branch circuit
Add'I branch circuitr—
Service
0-600V not over 2004 -
0-600V & over 2004—
over 600V1
Temp PP/Piggy Back
Sub Panel
Other
Bathroom Quantity
Plumbing Quantity
Water closet(toilet)I
Backflow device up to 2'r
Bidet
Backflow device over 2"r
Urinal F__
Regulatorsl'
Bath Tubl
Lawn Sprinkler System
Shower stalll
Roofdrainsl
Lavatory(basin)r
Hose bibbl
Hydro -massage tubF_
Drinking fountain
Kitchen
Kitchen sink r
--- -
Grease trap F—
Grease interceptorf—
Garbage Disposal
- - -
P-trap
Bar sink
Sewer
Vegetable sink
Newsewerl
Dishwasher
Sewer alter/repair
Laundry/washing trap
Sewer abandonments
Ice maker
Floor sink
coo
1 /cj oo
Miscellaneous
Floor drainf
ipingl
Waterater so softener—
Water heater
\ J�%'•�//Z i b
Lavatory (basin)I
Gas sys up to 4 outletsf—
Gas sys # of outlets over 4,
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