HomeMy WebLinkAboutE2023-0773 - Permit Application (3)Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
:S U /
F_ 2.Owner's Name Last I 'jy First
Owner's Street Address /� F, �
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Telephone Owner's E-mail Address
- 2131
Floor F_ Suite
LRo%od
1 D .) State ��., Zip F
F_ 3. Applicant's Name Last /r
M -1
First
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A licant's Street Address
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CityL/1'Y)✓/�l�j{1 /X
GLate
Zip
Telephone ry�(�Gi�CS' Applicant's E-mail Address
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F_ 4. Contractor's Name Last N��t
First
State Lic#
Contractor's Street Address
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77f fi
City F
r �J ,
State
Zip 7
Telephone �sVontractor's E-mail Address
ib
L Business Lic#
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Mechanical
up to 100,000 btu:
over 100,000 btu:F--
wall/Floor heaters :F--
Heat Pumps/Package Units
up to 100,000 btu::�
up to 1,000,000 btu
up to 1f 750,000 btu:
> 1, 750,000 btu:
Boilers/Compressors
up to 3 HP:r-
3 HP-15 HP::_
15 HP-30 HP11
30 HP-50 HP::
>50 HP:r__—f
Air Handling Units
up to 10,000 CFM::—
> 10,000 CFM:I
VAV Box:I--
Repair/Alter/Add HVAC
Number of Zones/ --
Ventilation
Bathroom Fan.:
Exhaust Fan-, r—
Attic Exhaust:[ --
Residential Hood:;
Commercial Hood
Metal Fireplace -I
Gas Une:�—
Fires rlamnrrc
Electrical I ',(4�Z"'' Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F:r--
Multi Family S.F:I—v
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total Fixtures:
Total Low Voltage:_
Separate Circuit::
Motors/Transformers
0-1 HP or KVA::—
1-10 HP or KVA::
10-50 HP or KVA::
50-100 HPor K/A:�
Over 100 HP or KVA:�f
Signs
One branch circuit:�—
Add'I branch circuit
Service
0-600V not over 200A::�
0-600V & over 200A:F__
over 600V:1r_
Temp PP/Piggy Back:lI—
'%o Sub Panel:i1
CYYT Other, F_
cl�
Water closet (toilet):[—
Bidet:7-
Udnal:Iv
Bath Tub:
Shower stall:
Lavatory (basin):(®
Hydro -massage tub::_
Kitchen
Kitchen sink:I
Garbage Disposal::—
Bar sink::
Vegetable sink:
Dishwasher�—
Laundry/washing trap:ri
Ice maker:
Floor sink:I—�
Miscellaneous
Floor drain: ��
Water piping:: -
Water softener:
Water heater:�,_
Lavatory (basin):r—
Gas sys up to 4 outlets:;I
Gas sys # of outlets over 4:r—
Backflow device up to 2"
Backflow device over 2"
Regulators::
Lawn Sprinkler System:
Roofdrains::
Hose bibb::
Drinking fountain
Grease trap:('
Grease interceptor.
P-trap:
Sewer
New sewer:
Sewer alter/repair:
Sewer abandonment r—