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Home My WebLink AboutX2019-0525 - Permit ApplicationJKL / Worksheet for Combo Building & Solar Permit Application saw COmm'l F_ Residential City of Newport Beach - Building Division!!! NOTE: PLAN. CHECK FEES DUE AT TInnF nF ci IRMITTGI Building r GTading F -Drainage Wlec KMech I— Plum Cu Yd Cut Cu Yd Fill Project Address (Not mailing address) r Flood f— Fire F- Liq F_ Landslide F_N/A Floor Suite No Description of Work , ri Use ConstType �1-A IA'i) i) —"--i #Stories' �p #Units (if Res) - New/Add SFRemodelRemodel SF 21126--I Garage/New/Add{ F I Valuation $ Material/LaborFtr� OWNER'S NAME Last 1 bANt4 �n-1N�S First Owner's Address viS Q Genoa P\ u0Olwnees E-mail Address 9'v4 UbN K,RWN -PHA oo nVKT�-col�11645-CH �N,�� City I l`t ��'" State ��e --I ZIP n Telephone 1-1 I -015 � c 1VAFM APPLICANT's NAME Last VU NK First i Applicant's Address Applicant's E-mail Address 10201 WN Y -t WAt AVl= 6ur/r�jr� 12b kJ�N Sor.MIN.c�M City I►W Slate I C..�l i Zip q';1 Z Telephone 9.-e)q . UC)8 2 ARCHITECT/DESIGNER'S NAME LastGY2�I 0 First d1e�S�t`l Lic. No. g bite Desi nees Address rcecUDesigner's E-mail Address Ahiti t�wl AW VON ►P► �r� � r�1a .�ilA� C.oM. � City IYWr��: State Zip Fq12o ! Telephonegz49 -77q 0: 5a I ll�I ENGINEER'S NAME Last �- First Lic. No. i Engineer's Address Engineer's E-mail Address City State F Zip F Telephone CONTRACTOR'S NAME/COMPANY rfj �x �U �,GiPA V rCe. Lic. No. (i)05_n791 Class Contractor's Address Contractor's E-mail Address She. ��u�C—p��1—:-.5�� (� /rnpr,k - (a e(,i c </co,,,,� City is 1X91 1 C State C Zip Telephone /�% I 1 t► Ytiv 7 % KJQ-7 �7 Cj7 1 SETBACKS REAR SETBACKS FRONT PERMIT NO. j(ZO 100.51 SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. M 42,- Z5 1-7 USE ZONE DEVELOPMENT NO PLAN CHECK FEES $ 16-76, Job Address: CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 COMMERCIAL MECHANICAL, ELECTRICAL, AND PLUMBING QUESTIONNAIRE FOR PLAN REVIEW WAIVER The above -proposed project may require electrical, mechanical, and or plumbing plan checking. The following questions are regarding the new proposed work and the applicable areas it serves. If the answer to a question below is "YES," a plan check is required for the Electrical, Mechanical, and/or Plumbing portion of work. To expedite the permit process, please submit this questionnaire along with an application and three (3) sets of plans. NOTE: The Chief Building Official may make exceptions for minor work, additions, and alterations. COMMERCIAL TENANT IMPROVEMENTS ONLY GENERAL NO YES 1. Is the area of work more than 2,500 square feet? ❑ 2. Is the area of work for OTHER THAN an occupancy classification and ❑ (use) of B (office), or M (retail)? 3. Does the area of work require a concurrent review from any other City ❑ department or outside agency (i.e. Health, Fire, or Public Works)? PLUMBING NO YES 4. Does the work include more than 9 plumbing fixtures? ❑ 5. Is the potable water piping 2 -inches or greater? ❑ 6. Does the work involve the installation of any pumps? E( ❑ 7. Does the work include a gas system other than typical low pressure .f ❑ system? 8. Are there any installations, alterations, or relocations of a grease ' L3interceptor and or clarifier? 9. Is the plumbing work above the ground floor in a high-rise building? 4,Q J ❑ 1 MECHANICAL NO YES 10. Does the work include any refrigeration equipment? 2 ❑ 11. Does the work include new rooftop equipment weighing a total of 250 lbs. ❑ or more? 12. Does the work include altering the existing smoke detection system in the ❑ air plenum? 13. Does the work include duct work with fire and or smoke dampers or duct ivi L3extensions over 25 feet? 14. Are there any new -installations containing a commercial type kitchen • ❑ hood, Types I or II? ELECTRICAL NO YES 15. Does the work include a new service, sub panel, or transformer rated ❑ over 400 amps? 16. Does the work involve more than 5 branch circuits? ❑ 17. Indoor lighting: Any new or replacement lighting over 50% of the existing ❑ lighting in the area? 18. Outdoor lighting: Any new or replacement lighting over 50% of the ❑ existing luminaries in a permitted area? 19. Does the work involve any high voltage installations (over 600 volts)? ❑ ITEMS NOT ELIGIBLE FOR M.E.P. PLAN REVIEW WAIVER PLUMBING • New restroom facilities • Septic tanks, cesspools • Chemical waste • Combination waste & vent MECHANICAL • Boilers • Spray booth • Fire and/or smoke damper • Medical gas system • Medium pressure gas piping I certify that the above information is true and correct. Signature: Date: Print Name: r— Phone #: Forms\COMMERCIAL MechaoicalElecdicalPlumbingPimCheckQues6omaim 2 ELECTRICAL • OSHPD 3 uses • Dock or harbor power • Photovoltaic or standby generator • Fuel cells COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box. 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.aov 1 (949) 644-3200 HAZARDOUS MATERIALS QUESTIONNAIRE If the answer to any of the questions below is yes, applicant must contact the Fire Prevention Office, 100 Civic Center Drive, P.O. Box 1768, Newport Beach, CA 92658-8915. Telephone: (949) 644-3106. Telephone Mailing Address ` City State Zip YES NO ❑ X Will your business activity generate Hazardous Waste in any quantity, in any physical form (solid, liquid, gas)? 2. ❑ ® Will your business at any one time store, use or handle Hazardous Substances in quantities equal to or greater than 55 gallons, 500 pounds or 200 cubic feet of compressed gas? 3. ❑ ® Will your business store, use or handle Carcinogens or Human Reproductive Toxins in any amount? 4. ❑ [` Will your business use an existing or install an Underground Storage Tank for Hazardous Substances or Hazardous Wastes? 5. ❑ . ® Will your business store, use or handle Acutely Hazardous Materials? 6. ❑ ® If your business will be handling Acutely Hazardous Materials, will your business be located within 1,000 feet from the outer boundary of a school? Briefly describe the nature of the business activity: �� LM Printed Name of Respondent: Circle one: owner tenant lessee architect Id iK5� I ndltf pe ' ry that to the best of my knowledge and belief the responses made herein are true a H�� tgnature of Respon Date For NBFD-Fire Prevention Use Only YES NO Reviewed By: Date: Business Plan Required ❑ ❑ Plan Check No. FormslHe quest 3/11/09 South Coast Air Quality Management District 21865 Copley Drive, Diamond Bar, CA 91765-4182 a a y' , 1 (909)396-3529- littl3://www.aqiitd.gov Air Quality Permit Cheddist California Government Code Section 65850.2 prohibits cities from issuing an occupancy permit to a business without clearance from the local air quality agency. This Checklist will determine if you need to obtain clearance from the South Coast Air Quality Management District (AQMD). Company Name: Property Address: City: Contact Person: Type of Business: Fax Number: e-mail addres . Applicant (print name) VP Signature: Date: Will the facility have any of the following equipment? Yes ❑ No Charbroiler Dry cleaning machine Spray booth Printing press (screen/lithographic/flexographic) Internal combustion engine greater than 50 HP (excluding motor vehicles) Boiler/combustion equipment (greater than 1 million BTU/hr. maximum input) Abrasive blasting cabinet/room Baghouse/cartridge-type dust filter/scrubber Motor fuel storage and dispensing equipment Will any of the following operations be performed? Application of paints or adhesives Etching, plating, casting, or melting of metals Molding, extruding, or curing of plastics Mixing and blending of liquids and/or powders Storage of acids, solvents, organic liquids, or fuels Production of fumes, dust, smoke, or strong odors Yes ❑ No 1 Iff you answered "No" to both questions, this checklist is your clearance from AQMD. If you answered "Yes" to either question, you must contact AQMD to determine if air quality permits are required. If permits are needed, AQMD will assist you in submitting permit application(s) and then provide you with a clearance letter. You can call AQMD at their Small Business Assistance Office at 1 -800 -CUT -SMOG (1-800-288-7664). Revised November 2006