HomeMy WebLinkAboutH2021-0669 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application EWA
'"Prin4"f-orm of Rm
City of Newport Beach z ,
1.Proj-elcBuilding Division " a
Project (Not mailing address) Building Permit No. %ozi,_.d66--_-_.. __ ...I 2t{0%,.ZOiq G</CO PN.P
`
.___�T3` ___%e41..✓_tew_c(F�_ _.__ Floor Suite
IJ 2.Owner's Name Last First
Owner's Street Address
!s_ Gar�O✓g- -- / (d��i r I_S`_ .. --- City WcqOi 4 State �! Zip �4 7 _
Telephone F Owner's E-mail Address
-7 3.Applicant's Name Last First _
A licant's Street Address _
City State Zip
Telephone Applicant's E-mail Address
4. Contractor's Name Last j)p vs/�n0i_ First 7777 State Lic#
Contractor's Street Address
Telephone Ii�9. ,>�'3_,-..3407 Contractor's E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 6tu:[—!I
wall/floor heaters.:7
Heat Pumps/Package Units
up to 100,000 btu:
up to 1,000,000 btu:
up to 1, 750,000 btu::
> 1, 750,000 btu:��!
Boilers/Compressors
up to 3 HP:
3 HP -15 HP:C—i
15 HP -30 HP:
30 HP -50 HP:r—I
>50 HP:�
Air Handling Units
up to 10,000 CFM::
> 10,000 CFM:
VAV Box:7
Repair/Alter/Add HVAC
Number of Zones:!
Ventilation
Bathroom Famr—
Exhaust Fam:7
Attic Exhaust[ --
Residential Hood:'
Commercial Hood:F777
Metal Fireplace:
Gas LineF__
Fire Dampers:F—
CitySa n-_G_�PState r Zip �L_G
Business Lic# 6_15A ggZ,
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 &2 Family S.F::
Multi Family S.F:F-7-77,
Receptacle, Switch Lighting Outlets
Total Outlets
Lighting Fixtures
Total Fixtures: 7
Total Low Voltage
Separate Circuit::
Motors/Transformers
0-1 HP or KVA::
1-10 HP or KVA::
10-50 HP or KVA:F-----
50-100 HP or KVAF7
Over 100 HP or KVA:
Signs
One branch circuit'
Add'I branch circuit::
Service --
0-600V not over 200A:7
0-600V& over 200AF77
over 600V::I
Temp PP/Piggy Back:!
Sub PaneL•F-----';
Other.F
Water closet (toilet):
Bidet::
Urinal
Bath Tub[77
Shower stalL•F___1
Lavatory (basin):
Hydro -massage tub:—!
Kitchen
Kitchen sink:
Garbage Disposal::l
Bar sink:F77
Vegetable sink
Dishwasher 77
Laundry/washing trap::
Ice maker[77
Floor sink
Miscellaneous
Floor drain:!
Water piping:'..
Water sokener.�
Water heater:
Lavatory (basin):
Gas sys up to 4 outlets::
Gas sys # of outlets over 4:r—!,
Backflow device up to 2":7I
Backflow device over 2"::
Regulators::
Lawn Sprinkler System[—__
Roof drains:1
Hose bibb:�
Drinking fountain F_7
Grease trap 77
Grease interceptor:;
P -trap::
Sewer
New sewer:
Sewer alter/repair.
Sewer abandonment:;