HomeMy WebLinkAboutH2022-0325 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical/ Plumbing Application
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City of Newport Beach p
Building Division 2��7-Zol p
1. Project Address (Not mailing address) Building Permit No. MZUZ2-03 � 11 •� `+��7
U`m WDO OL_ �Floor F_ Suite
I 2. Owner's Name Last First
Owner's Street Address
CiTy State F_, Zip F_
Telephone F Owner's E-mail Address
I— 3. Applicant's Name Last (3 A* c— � First
A Iicant's Street Address
City State F_ Zip r
Telephone �— Applicant's E-mail Address
r 4. Contractor's Name Last a-Q `(,,,,,, ./t'G• First State Lic#
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Contractor's Street Address
ID�sR S �' Cu>wy Or\ �i�u.i City _ _ vl _ .. _ State [5F Zip Gi 510
Telephone ly—`i�_s�(sy Contractor's E-mail Address Qtr •r Obm 'Business Lic# Sj r/
ch }ttiry @9ttta G -
Mechanical
Furnace Quantity
up to 100,000 btur—
over 100,000 btus—
wall/floor heaters
Heat Pumps/Package Units
up to 100,000 btul—
up to 1,000,000 btu.
up to 1, 750,000 btul—
> 1, 750,000 btur—
Boilers/Compressors
up to 3 HPF3
3 HP-15 HIP
15 HP-30 Hk
30 HP-50 HPs—
>50 HPs—
Air Handling Units
up to 10,000 CFMFT_
> 10,000 CFMr—
VAV Boxr—
Repair/Alter/Add HVAC
Number of Zoness—
Ventilation
Bathroom Fanr—
Exhaust Fan[ ---
Attic ExhaustF_
Residential Hoods —
Commercial Hoodr—
Metal Fireplacer—
Gas Liner_
Fire Damperss—
Electrical
New Construction Quantity
1 & 2 Family S.Fs
Multi Family S.Fs
Receptacle, Switch Lighting Outlets
Total Outlets
Lighting Fixtures
Total FIxturesr
Total Low Voltage
Separate Circuit
Motors/Transformers
0-1 HP or KVAs
1-10 HP or KVAs
10-50 HP or KVAs
50-100 HPorKVAf—
Over 100 HP or KVAF—
Signs
One branch circuits"
Add'I branch circuitF—
Service
0-600V not over 200A5
0-600V & over 200A5
over 600V5
Temp PP/Piggy Back
Sub Panel
Other
Bathroom Quantity Plumbing Quantity
Water closet (toileUr
Bidet s
Urinal s
Bath T.1
Shower
Lavatory (basin)
Hydro -massage tubs
Kitchen
Kitchen sink s
Garbage Disposal
Bar sink
Vegetable sink
Dishwasher—
Laundry/washing traps
Ice makers
Floor sinks
Miscellaneous
Floor drains
Water pipings
Water softeners
Water heaters
Lavatory (basin)s
Gas sys up to 4 outletss
Gas sys # of outlets over 45
Backflow device up to 2"r
Backflow device over 2"r
Regulators
Lawn Sprinkler System
Roof drains
Hose bibbs
Drinking fountain
Grease trap
Greaseinterceptof
P-traps
Sewer
New sewer
Sewer alter/repairs
Sewer abandonments