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P2022-0064 - Permit Application
Worksheet for Electrical/Mechanical/ Plumbing Application F s Print Form City of Newport Beach F Building Division �L,FOAN�' 1. Project Address (Not mailing address) Building Permit No. _ 7- ©. gzr _, Suite /C✓_?-_____.__—____ 1- 2.owner's Name Last First Owners Street Address --4r C+C_.._ SF L!_r._?,,In City state zip t� /�._..._._.: Telephone Owner's E-mail Address 3. Applicant's Name Last ��� First Applicanfs Street Address _ c2 city i(( ^ei _ State Gil- Zip _I Telephone " - y-Tm Applicants E-mail Address iJ4. Contractor's Name Last - First State Lic # ,//�---------- �f -- --' Contractor's Street Address _ _. tiiy!..' C.ar7t7✓h! l- iPln � city _State Zip ?? 3 " ----— __ Telephone S6z S�'lc'^'27y4 Contractor's E-mail Address Business Lic# Mechanical Furnace Quantity up to 100,000 btu J over 100,000 btu— wall/floor heaters[777 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:74 3 HP-15 HP:7 15 HP-30 HPF---7 -- 30 HP-50 HP:. - >50 Air Handling Units up to 10,000 CFMF-71 > 10,000 CFMCJ VAV Box: Repair/Alter/Add HVAC Number of Zones — Ventilation Bathroom Fanf Exhaust Attic Exhaust Residential Hood— Commercial Hood:r7 Metal Fireplace:r7 Gas Line:�— Fire Dampers:F— Electrical New Construction Quantity -- 1 & 2 Family S.F: Multi Family S.FF—J Receptacle, Switch Lighting Outlets Total Outlets:, Lighting Fixtures Total Fixturesf— Total Low Voltage:-:_ Separate Circuit Motors/Transformers 0-1 HP or KVAF — 1-10 HP or KVAT 10-50 HP or KVA: 50-100 HP or KVA:` Over 100 HP or KVA:r— Signs One branch circuit Add'I branch circuitr� Service 0-600V not over 200AF 0-600V& over200Af-- over 600V: Temp PP/Piggy Back Sub Panel Other::_ Bathroom Quantity Plumbing .Quantity. Water closet (toilet): Backflow, device up to 2" Bidet Backflow, device over 2J - Urinal Regul Bath Tubl Lawn Sprinkler Sy Shower stall Roof Lavatory(basin)ll Hose Hydro -massage tub: Drinking Kitchen Kitchen sink Garbage Disposal Bar sink Vegetable sink Dishwasher: Laundry/washing trap 1 Ice maker' Floorsink:� Miscellaneous Floordrainf Water piping: Water softener:_ Water heater: Lavatory (basin): Gas sys up to 4 outlets Gas sys # of outlets over 4:F— Grease P-trap: Sewer New sewer Sewer alter/repair_ Sewer abandonment: