HomeMy WebLinkAboutH2022-0564 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application �EW�RT
__Print Form City of Newport Beach
Building Division -a r
}-�-CgCIFORN'
1. Project Address (Not mailing address) Building Permit No.
WV1.41�
)o +c- DC i V� 1 /VENT® MAO ,C► , lZ Floor F_ Suite
(� 2.Owner's Name Last 1— First W t J7
Owner's Street Address
coLotJ10(f_ XIC _A<W4~ City Ak) A/ 1--RjC"State Zip I 126 o
Telephone 17 Owner's E-mail Address I At
F/3.Applicant's Name Last H(.(&1A) First � s
Applicant's Street Address
City State Zip Z
Telephone LtT( <- j Applicant's E-mail Address 1_ '
r 4. Contractor's Name Last First 3 State Lic #
Contractor's Street Address
rZ p vp City State Zip z 2-
Telephone 5�11151—;kMContractor's E-mail Address PCIP Business Lic #
Mechanical
Furnace Quantity
Electrical
New Construction Quantity
up to 100,000 btu —
1 & 2 Family S.F:F
over 100,000 btu::—
Multi Family S.F]
wall/floor heaters:F
Receptacle, Switch Lighting Outlets
Heat Pumps/Package Units
Total Outlets:r—
up to 100,000 btuF
Lighting Fixtures
up to 1,000,000 btu:r�
up to 1, 750,000 btuf
Total Fixtures::—
> 1, 750,000 btu:!
Total Low Voltage:F_
Boilers/Compressors
up to 3 HPf
Separate Circuit:r
3 HP-15 HPf-
Motors/Transformers
0 1 HP or KVA::-
15 HP-30 HPF_
1-10 HP or KVA::
30 HP-50 HP::_
10-50 HP or KVA::—
>50 HP:-
50-100 HP or KVA:F_
Air Handling Units
up to 10,000 CFM:F
Over 100 HP or KVA:F
> 10,000 CFM::—
Signs
VAV Box-F
One branch circuit:
Repair/Alter/Add HVAC
Add'I branch circuit:_
Number of Zones—
Service
Ventilation
Bathroom Fan:`
0-600V not over 200AF
Exhaust Fan:F—
0-600N &over 2004—
Attic Exhaust:F_—
over 600VT_
Temp PP/Piggy Back:: —
Residential Hood::
Sub Panel:: —
Commercial Hood::—
Other:F—
Metal Fireplace:
Gas Line::
Fire Dampers]
Bathroom Quantity Plumbing Quantity
Water closet (toilet):
Bidet:.
Urinal :F
Bath Tub:`
Shower stall:
Lavatory (basin):
Hydro -massage tub:
Kitchen
Kitchen sink
Garbage Disposal:
Bar sink::
Vegetable sink:
Dishwasher
Laundry/washing trap:
Ice maker:F—
Floor sink:
Miscellaneous
Floor drain:
Water piping:
Water softener:
Water heater:
Lavatory (basin):
Gas sys up to 4 outlets:F�
Gas sys # of outlets over 4::_
Backflow device up to 2":r—
Backflow device over 2":r
Regulators]
Lawn Sprinkler System:: —
Roof drains:: —
Hose bibb:l
Drinking fountain:r—
Greasetrapf
_..... _ ..
Grease interceptor:
P-tra p:1
Sewer
New sewer:r—
Sewer alter/repair:1
Sewer abandonmend