HomeMy WebLinkAboutH2022-0462 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address)
€9L__S1X1Xe LN.
Building Permit No. q io 'ZZ _ 0 W 2
E hl 70 -r- 6634CH l + 42 6 (- o Floor Suite
f- 2.Owner's Name Last
Owner's Street Address
City
Telephone Owner's E-mail Address
F_ 3. Applicant's Name Last
Applicant's Street Address
Telephone I Applicant's E-mail Address
Fes. Contractor's Name Last C a R Q LL O
Contractor's Street Address
7(ba .0 I..Assc-u.. s r
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btu:
wall/floor heaters:
Heat Pumps/Package Units
up to 100,000 btu:I
up to 1,000,000 btu:
up to 1, 750,000 btu:
> 1, 750,000 btu:l
Boilers/Compressors
upto3HP:l
3 HP-15 HP:
15 HP-30 HP[
30 HP-50 HPF_
>50 HP:
Air Handling Units
up to 10,000 CFM:
> 10,000 CFM:
VAV Box:
Repair/Alter/Add HVAC
Number of Zones:
Ventilation
Bathroom Fan]
Exhaust Fan:l
Attic Exhausd
Residential Hood:
Commercial Hoodl
Metal Fireplace f —
Gas Line:
Fire Dampers:
First
First
State I— Zip I����-��
City I State I Zip
First F R AN IC State Lic # 16 L452_6 t
City D ll tie State CJ Zip
III PL 3L-1II-Y 1C» I t r4mIC$ to y V\VGG(0,03rnel, I. e'a/ % ousiiiess ucs ICI 5C)0b-3'78J
Electrical
New Construction Quantity
1 & 2 Family S.F:F-
Multi Family S.F:-
Receptacle, Switch Lighting Outlets
Total OutletsF—
Lighting Fixtures
Total Fixtures:
Total Low Voltage:
Separate Circuit:r-
Motors/Transformers
0-1 HP or KVA:_
1-10 HP or KVA:_
10-50 HP or KVA:_
50-100 HP or KVA:_
Over 100 HP or KVA:r-
Signs
One branch circuit:[-
Add'I branch circuit:
Service
0-600V not over 200A:_
0-600V & over 200A:
over 600V:-
Temp PP/Piggy Back:F—
Sub Panel:
Other:
Bathroom Quantity
Water closet (toilet): -
Bidet :F_
Urinal :F_
Bath Tub:
Shower stall:
Lavatory (basin): -
Hydro -massage tub: -
Kitchen
Kitchen sink: —
Garbage Disposal:
Bar sink:
Vegetable sink:F—
Dishwasher
Laundry/washing trap:
Ice maker:
Floor sink:l_
Miscellaneous
Floor drain:r
Water piping:F
Water softener:F—
Water heater: -
Lavatory (basin):F-
Gas sys up to 4 outlets:[
Gas sys # of outlets over 4:I_....
Plumbing
Quantity
Backflow device up to 2":F
Backflow device over 2":-
Re g u I ato rs:l.Y._...-.--._.._
Lawn Sprinkler System: -
Roof drains:_
Hose bibb:—
Drinking fountain:F_
Grease trap: -
Grease interceptor:F—
P-trap:
Sewer
New sewer:F-
Sewer alter/repair:
Sewer abandonment:F