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HomeMy WebLinkAboutXR2022-2815 - Permit ApplicationPrint Form ~—Worksheetfor Electrical/Mechanical/ Plumbing Appli-e6fian -- City of Newport Beach Building Division 1. Project Address (Not mailing address) t C� &U KCU-4,-sgpA-e , P. 1. Building Permit No. r 2. Owner's Name V Last S Ownt(e�'r's� JA._31Vs Stree ddress � _ -� �-- --- --- -"-�-----"-- - --- .__-_ pf -- _-o.tl.S C�Ct,1_. �_n City Telephone7-0 Owner's E-mail Address j✓I IA. f "off" �r�FOPM" -" -- '----'Floor 'I _. Suite First PA State Zip _ OGr, r 3. Applicant's Name Last J L First — — —_ Applicant's Street Addres �LIi City -_s -. State Zip _ �P (� Telephone t) S ),Applicant's E-mail Address r 4. Contractor's Name Last First ____._ - State Lic It yi Conttraacc�toes Street Address ry -- l- ----- � city e Zip Telephone _ �.- ?(contractor's E-mail Address Lnc,_ _ _Ll%r'1l ifs nes�U,# -_� , 7� 0_!;O Mechanical Furnace Quantity up to 100,000 btull over 100,000 btuF— wall/floor heaters Heat Pumps/Package Units up to 100,000 btuF — up to 1,000,000 btu:r— up to 1, 750,000 btul— > 1, 750,000 btu-- Boilers/Compressors up to 3 HPI 3 HP-15 HPI 15 HP-30 HPF_- 30 HP-50 HPF >50 HPf— Air Handling Units up to 10,000 CPMI- > 10,000 CFMI- VAVBoxI Repair/Alter/Add HVAC Numberof Zones Ventilation Bathroom FanF_— Exhaust Fans Attic Exhaustf— Residential Hood Commercial Hoodi— Metal Fireplace:F-- Gas Linel Fire DampersF— Electrical New Construction Quantity 1 &2 Family S.Ff__1 Multi Family S.F:F__'.' Receptacle, Switch Lighting Outlets Total Lighting Fixtures Total Fixtures: Total Low Voltage:F-: Separate CircuitFl. Motors/Transformers 0-1 HP or KVA:F-- 1-10 HP or KVAf- 10-50 HP or KVAF- 50-100 HP or KVAFl Over 100 HP or KVA:1 Signs One branch circuit Add'I branch circuit:F— Service 0-600V not over 200A:r! 0-600V & over 2004 — over 600V:r- Temp PP/Piggy Back:F— Sub Panel:F-7— Other: v Bathroom Quantity Plumbing Quantity Water closet(toilet)C—' Backflow device up to 2"r—. Bidet f —', Backflow device over 2"F —; urinal F Regulatorsf— Bath Tubl Lawn Sprinkler System:F— Shower stall Roof drainsf— Lavatory (basin)I`' Hose bibbf— Hydro-massage tubf Drinking fountainf— Kitchen Kitchen sink Grease trapF— Garbage Disposal Grease interceptor Barsinkf—'. P-trapF— Sewer Vegetable sink New sewerF— Dishwashel Sewer alter/repairF— Laundry/washing trap— Sewer abandonment_ Ice makerf— Floor sinkF— Miscellaneous Floor drain( Water oioinai Water Lavatory (basin)i- Gas Sys up to 4 outlets f Gas Sys # of outlets over 4l-