HomeMy WebLinkAboutH2023-0571 - Permit Application (3)Worksheet for Electrical/Mechanical/ Plumbing Application
Print Form City of Newport Beach
Building Department
1. Project Address (Not mailing address) Building Permit No.
1888 San Clemente Floor 1st Suite 150
r 2. Owner's Name Last First
Owner's Street Address
City F_ State F_ Zip
Telephone I Owner's E-mail Address
F_ 3. Applicant's Name Last First
A licant's Street Address
City State F_ Zip
Telephone F_ Applicant's E-mail Address
F_ 4. Contractor's Name Last C��%�.7za j7- -� ! Y� st State Lic#
Contractor's �Street Address� �
G,. Z_o Wn" -4 V-1'49Le; city �`�( d/�'I�-2fY1 State 4--- Zip CZ Iw•7
Telephone 7/L`.-Contractor's E-mail Address <'•tiaE%t✓7'/ J C i Ld l��z�. CrC-c'tF?�usiness Lic# f�j��%f0�
Mechanical
Furnace Quantity
Electrical
New Construction Quantity
Plumbing
Bathroom Quantity Quantity
upto100,0001btu::
1 & 2 Family S.F:
Water closet(toilet):r— Backflowdevice upto2"r—
over 100,000 btu:
Multi Family S.F:
Bidet:: Backflow device over 2"::
wall/floor heaters::
Receptacle, Switch Lighting Outlets
Urinal :_ Regulators::
Heat Pumps/Package Units
Total Outlets
Bath Tub:: Lawn Sprinkler System
up to 100,000 btu:_
Lighting 9 9 Fixtures
Shower stall:: Roof drains::
up to 1,000,000 btu::
up to 1, 750,000 btu:r—
Total Fixtures:
Lavatory (basin)F— Hose bibb:�
> 1, 750,000 btu::
Total Low Voltage:—
Hydro -massage tu6:: Drinking fountain::
Boilers/Com ressors
P
up to 3 HP:
Separate Circuit::
Kitchen Grteretrap::
Kitchen sink::
Grease interceptor:-
3 HP-15 HP:r—
MotorsRranzformers
Garbage Disposal::
P-trap::
15 HP-30 HP:-
0-1 HP or KVA:
Bar sink:: Sewer
1-10 HP or KVA:
Vegetable sink:— New sewer:
30 HP-50 HP:r-
10-50 HP or KVA:
Dishwasher Sewer alter/repairr—
>50 HP::
50-100 HP or KVA::
Laundry/washing trap:: Sewer abandonment: —
Air Handling Units
up to 10,000CFMJ—
Over 100 HP or KVA:
Ice maker::
>10,000 CFM:r—
Signs
Floorsink:F—j �C) ``U
I 1.1
VAV Boxo�
One branch circuit:
Miscellaneous
Repair/Alter/Add HVAC
Add'I branch circuit:
Floor drain
Number of Zones:—
Service
Water piping
Ventilation
Bathroom Fan:—
:
0-600V not over 200A:
Water �
'1
eater: q-C/!/V (/> v ✓
Exhaust Fan:
Ob00V &over 200A::
rh
Water heater::
OS7
Attic Exhaust::
over 600V:
Lavatory (basin)�— 1. 1 �`' ��
Residential Hood::
Temp PP/Piggy Back:
Gas sys up to 4 outlets::
Commercial Hood::
Sub Panel:
—
Gas sys # of outlets over 4::
—
Other::
Metal Fireplace::
Gas Line:: —
Fire Dampers:r—