HomeMy WebLinkAboutX2016-0564 - Permit Application (4)Czo& & za ��
Worksheet for Electrical/Mechanical/ Plumbing Application CEWPo
Print Form o� R
City of Newport Beach
Building Division " z
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1. Project Address (Not mailing address) Building Permit No.
� Floor F— Suite r�
r11 2.Owner's Name Last First l
Owner's Street Address
City State r-1 Zip �— J
Telephone j E-mail Add Owner's ess l
I � _
r! 3. Applicant's Name Last First
Applicant's Street Address
City I State fI Zip
Telephone Applicant's E-mail Address
411
, . Contractor's Name Last First
I _ � 1 v \�� - State Lic 1�
4r
Contractor's Street Address \\
F-1. 1 - ''
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Telephor.
1 - ..._.... 4..V� ess Lic #
Mechanical
Furnace Quantity
up to 100,000 btu:—'
over 100,000 btu:�—
wall/floor heatersf—
Heat Pumps/Package Units
up to 100,000 btu:r
up to 1,000,000 btuf!
up to 1, 750,000 btu:f
> 1, 750,000 btu:r— -
Boilers/Compressors
up to 3 HP:r—'
3 HP-15 HP:f --
15 HP-30 HPI
30 HP-50 HP:[!
>50 HP:[ —'I
Air Handling Units
up to 10,000 CFM:f
> 10,000 CFM:f --,
VAV Box: -;
Repair/Alter/Add HVAC
Number of Zones:[
Ventilation
Bathroom Fan:F
Exhaust Fan:r�
Attic Exhaust:[ --�
Residential Hood:f
Commercial Hood:r—�
Metal Fireplace]
Gas Line]
Fire Dampers] --
Electrical
New Construction Quantity
1 & 2 Family S.F:r
Multi Family S.F:rY- v
Receptacle, Switch Lighting Outlets
Total Outlets:
-
Lighting Fixtures
Total Fixtures:.[
Total Low Voltage:f
Separate Circuiful
Motors/Transformers
0-1 HP or KVA:r—
1-10 HP or KVA:f -I
10-50 HP or KVA:f
50-100 HP or KVA:f —
Over 100 HP or KVAF
Signs
One branch circuit:[II
Add'I branch circuit:[
Service
0-600V not over 20OA:
0-600V & over20OA: FLi
over 600V:r�
Temp PP/Piggy Back:rWj
Sub Panel:—�
Other:F II
Bathroom Quantity
Plumbing Quantity
Water closet (toilet):r—1
Backflow device up to 2":F—I
Bidet:
Backflow device over 2":r�-v
Urinal :r—)
Regulators:r—1
Bath Tub:r—1
Lawn Sprinkler System:)
Showerstall: l
Roof drains:[ —I
Lavatory (basin):f�I
Hose bibb:FI
Hydro -massage tub:[-1 Drinking fountain:[ l
Kitchen
Kitchen sink F7
Garbage Disposalr�l
Bar sink:r_
Vegetable sink:[ i
Dishwasherr�l
Laundry/washing trap:r—�
Ice maker:[)
Floor sink:[
Miscellaneous
Floor drain:[—1
Water piping:[ —I
Water softener:[
Water heater:[
Lavatory (basin):r�
Gas sys up to 4 outlets:
F �
Gas sys # of outlets over 4:F II
Grease trap:[
Grease interceptor:
r—
P trap:[
Sewer
New sewer:r—1
Sewer alter/repair:fI
Sewer abandonment: -I