HomeMy WebLinkAboutXC2023-0015 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address)
Permit No.
10 a 7 I. V V ii/�L.(/(,(v� � ��.. Fluor
2. Owner's Name Last w VA-9 First
jOwn�er's�St�reet j d ess (-
1. `—'l/ t/ / u ! LO
''�� //�� City i l`r 3
Telephone 7!. - {/ L0j -rs E-snail Address
f— 3.Applicant's Name Last MEDINA First HEN
Applicant's Street Address
722S LA BAYA DR City ESTLAKE VILLAGE.
Telephone �18-735-7876 Applicant's E-rpa Address
4. contractor's Name Last � �.'r` _rG(,G( f Z L'.6 J&
Contractor's Street Address i'r�-,"
city
Telephone V[Cl 5�UV,
Mechanical
Furnace Quantity
up to 100,000 btu
over 100,000 btu:F—
wall/floor heaters.F—
Heat Pumps/Package Units
up to 100000 btu
up to 1,000000 btu
up to 1, 750,000 btu�—
> 1, 750,000 btui
Boilers/Compressors
up to 3 HIP :r
3 HP-15 HP -.F—
T 5 HP-30 HPF—
30 HP-50HP:F -
>50 HPT
Air Handling Units
up to 10,000 CFMr_
> 10,000 CFM:F—
VAV Box f —
Repair/Alter/Add HVAC
Number of Zonez F—
Ventilation
Bathroom Fan.—
ExhaustFan:F
Attic Exhaust:
Residential Hoodl
Commercial Hood:F—
Metal Fireplace: —
Gas Liner
Fire Dampers;
r—
E-mail Address
Electrical
New Construction Quantity
1 & 2 Family S,FF—
Multi Family S.Fr- -.
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total nxturesf—
Total LowVoltageF--.
Separate Circuit
Motorsrrransformers
0-1 HP or KVAF-
1-10 HP or KVA:-
10-50 HPorKVAF
50-100 HP or KVA�—
Over100 HPor KVA�--
Signs
One branch orcurtF—
Add'I branch circuitr—
Service
0-600V not over 200Ai
0-60oV & over 200A�—
over 6004 —
Temp PP/PiggyBadcr—
Sub Farrell
Other:—
Suite
State FrA Zip
State F~_ Zip 91362
._ ... .._._. State Lic#
State i/yam:.. Zip
i•�BBusiness Lic #
Bathroom Quantity
Plumbing Quantity
Water closet (toilet)—
Backflow device up to 2' f —
Bidet—
Backflow device over Xf—
Urinals —
Regulatorsf
Bath Tubr—
Lawn Sprinkler Systemi—
Shower stall
Roof drams
Lavatory (basin)
Hose bibbr
Hydro -massage tube Drinking fountainF
Kitchen
IGtchen sink
Garbage Disposal
Bar sink
Vegetable sink
Dishwasher
Laundry/washing trap
Ice maker
Floor sinkf—
Grease trap:—
Grease interceptor
P-trapf—
Sewer
New sewers
Sewer alter/repan f
Sewer abandonment —
Miscellaneous
Floor drainF—
Water pipings
Watersoftener cu I*
O�
4'
Water heater, v,
Lavatory (basin)-
Gas sys up to4outlets-
Gas sys # of outlets over 4F-
t\ • \
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