HomeMy WebLinkAboutH2022-0239 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application �EW�Rr
Print Form o° o
City of Newport Beach R uz?,- z
Building Division ( o St . Z-o �2 9aop„Px
1. Project Address (Not mailing address) Building Permit No.
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.._I Floor
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Suite
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2. Owner's Name Last
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First
Owner's Street Address
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city N !
State tH
zip 4 L �i60
Telephone
Owners E-mail Address
3. Applicant's Name Last
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First
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Applicant's street Address
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Ciry pal.-64
State 6-I
zip 17kZ 670---.
Telephone .__�y\_311,Z y_rr Applicant's E-mail Address
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4. Contractor's Name Last
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First
State Lic#
Contractor's Street Address
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city (
state eW
zip F cla(v
Telephone 144 ZnV`Is�t Contractor's E-mail Address
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/JBusiness Lic# I�
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Mechanical
Furnace Quantity
Electrical
New Construction Quantity
up to 100,000 btu:11
1 & 2 Family S.F:F7-
over 100,000 btuT77
Multi Family STF 1
wall/Boor heaters: J
Receptacle, Switch Lighting Outlets
Heat Pumps/Package Units
up to 100,000 btu :: —I
Total Outlets f 77
up to 1,000,000 btu:F-,
Lighting Fixtures
up to 1, 750,000 btu::
Total Fixtures•.
> 1, 750,000 btu:
Total Low Voltage
Boilers/Compressors
Separate Circuit—�!
up to 3 HP:F_77
3 HP-15 HP:r Z.__
Motorsli'ransformers
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_
15 HP-30 HPF ��
0-1 HP or KVAF
30 HP-50 HP::
1-10 HP or KVA:
10-50 HPor KVA:
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>50 HP:r—I
50-100 HPor KVA:�
Air Handling Units
up to 10,000 CFM:F
Over 100 HPor KVAF
> 10,000 CFM:F_—��
Signs
VAV Box: j
One branch circuit f 77
Repair/Alter/Add HVAC
Add'I branch circuit
Number of Zones:
Service
Ventilation
Bathroom Fan:? —I,
0-600V not over 200A:.
Exhaust Fan:F--,
0-600V& over 200A: I
--
Attic Exhaust::
over 600V::I
—
Residential Hood.ii
Temp PP/Piggy Back
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Commercial Hood:r—
Sub Panel:—'.
Metal Fireplace : —I
Other: i
Gas Line:
Fire Damnercl
Bathroom Quantity Plumbing Quantit
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Water closet (toilet)::I
Bidet'
i
Urinal::
Bath Tub: 7
Shower stall:?
Lavatory (basin)::
Hydro -massage tl
Kitchen
Kitchen sink:F77
Garbage Disposalf77
Bar sink::
Vegetable sink:
Dishwasher—
Laundry/washing trap
Ice maker:
Floor sink:
Miscellaneous
Floor drain:F_
Water pipingF7
Water softener:F
Water heal
Lavatory (basin)::'
Gas Sys up to 4 outlets r-
Gas Sys # of outlets over 4:F—
BackBow device up to 2"::
BackBow device over 2"::
Regulal
Lawn Sprinkler System:l
Roof drams:n
Hose Bibb::ll
Drinking fountain::
Grease trap:
Grease interceptor 77
P-trap:F—
Sewer
New sewerF_
Sewer alter/repalrF7
Sewer abandonmerill