HomeMy WebLinkAboutX2012-0080 - MiscISSW561 -2012
Worksheet for Building Combo Permit Application
City of Newport Beach - Building Division
NOTE: PLAN CHECK FEE DUE AT TIME OF SUBMITTAL
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APPLICANTS NAME Last
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ENGINEER'S NAME Last
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CONTRACTOR'S NAME/COMPANY
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ENERGY P/C FEE $ FIRE P/C FEE $ PERMIT NO. 2011-' a3 )C
DIN P/C FEE $
PLANNING P/C FEE $ PLAN CHECK NO. (7)tt5C
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/P M/MECH P/C FEES (914 PLAN CHECK FEE $
D PMENT # TOTAL FEES PAID $ s-.813-. cv2---
Job Address:
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
3300 Newport Boulevard I P.O. Box 1768 I Newport Beach, CA 92658
www.newportbeachca.gov I (949) 644-3275
COMMERCIAL
MECHANICAL, ELECTRICAL, AND PLUMBING
QUESTIONNAIRE FOR PLAN REVIEW WAIVER
3100 W . Ca/9rr /Ywy frectoomr t-*M 12 66 ?
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 (3) sets of plans.
NOTE: The Chief Building Official may make exceptions for minor work, additions, and
alterations.
COMMERCIAL TENANT IMPROVEMENTS ONLY
GENERAL
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 othef City
department or outside agency (i.e. Health, Fire, or Public Works)?
PLUMBING
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?
7. Does the work include a gas system other than typical low pressure
system?
8. Are there any installations, alterations, or relocations of a grease
interceptor?
NO YES
la CI
121/
NO
YES
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MECHANICAL NO YES
9. Does the work include any refrigeration equipment?
10. Does the work include new rooftop equipment weighing a total of 250 lbs.
or more?
11. Does the work include duct work with fire and or smoke dampers or duct
extensions over 10 feet?
12. Are there any new installations containing a commercial type kitchen
hood, Types I or II?
ELECTRICAL
13. Does the work include a new service, sub panel, or transformer rated
over 400 amps?
14. Does the work involve more than 5 branch circuits?
15. Indoor lighting: Any new or replacement lighting over 50% of the existing
lighting in the area?
16. Outdoor lighting: Any new or replacement lighting over 50% of the
existing luminaries in a permitted area?
17. Does the work involve any high voltage installations (over 600 volts)? ❑
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NO YES
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❑ a'
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:
Print Name:
Phone #:
Vol) 729 —%yT7
FonnslMechanica[ElectncalPlumbingPlanCtieckQuestionnaire8-16-11
2
Date:
ELECTRICAL
• OSHPD 3 uses
• Dock or harbor power
• Photovoltaic or standby
generator
• Fuel cells
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