HomeMy WebLinkAboutXC2022-2113 - Permit Application (2)Print Form Worksheet for Electrical/Mechanical/ Plumbing Application EWER,
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— City of Newport Beach z
Building Division
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1. Project Address(Not mailing address) Building Permit No. XGag3a-a I J
360 San Miguel Dr.
Floor Suite �—
r 2. Owner's Name Last I Rhodes Development Lumpy" First
Owner's Street Address
Avocado Ave, Suite YU i City ewpo eac State F11 Zip "�
Telephone I Owner's E-mail Address
r 3. Applicant's Name Last
First
A licant's Street Address
ammo e u.e City Frpe rano eac State Zip s
Telephone rMum— Applicant's E-mail Address a@kw-architects.com
r 4. Contractor's Name Last First State Lic #
Contractor's Street Address
Telephone
Mechanical
Furnace Quantity
up to 100,000 btu:r
over 100,000 btu:r
wall/Floor heaters:r
Heat Pumps/Package Units
up to 100,000 btu: —
up to 1,000,000 btu:r
up to 1, 750,000 btu:r
> 1, 750,000 btu:r
Boilers/Compressors
up to 3 HP:r
3 HP-15 HP)
15 HP-30 HPr
30 HP-50 HPF_
>50 HPF__
Air Handling Units
up to 10,000 CFMr—
> 10,000 CFNAF
VAV Box:—
Repair/Alter/Add HVAC
Number of Zones:F
Ventilation
Bathroom Fan:r
Exhaust Fan:_
Attic Exhaust:r
Residential Hood:r
Commercial Hood:_
Metal Fireplace:[
---
Gas Line
Fire Dampers:F—
Contractor's E-mail Address
City F_ State F_ Zip
Business Lic #
Electrical I Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.Fr—
Multi Family S.F:r—
Receptacle, Switch Lighting Outlets
Total Outlets: 69
Lighting Fixtures
Total Fixtures 43
Total Low Voltage:r—
Separate Circuit:—
Motars/rransformers
0-1 HP or KVAF___
1-10 HP or KVA)-
10-50 HPor KVAF-
50-100 HPorKVA:r—
Over 100 HP or KVA)
Signs
One branch circuitr—
Add'I branch circuitf
Service
0-600V not over 200A)
0-600V & over 2004—
over 600Vr
Temp PP/Piggy Backr—
Sub Panel)
Other:r—
Water closet (toilet)
Bidet:r
Urinal
Bath Tub:r
Shower stallf—
Lavatory(basin):F
Hydro -massage tub:r—
Kitchen
Kitchen sink:r—
Garbage Disposal
Bar sink:r—
Vegetable sink:r—
Dishwasherr
Laundry/washing trap
Ice maker :r—
Floor sink:r—
Miscellaneous
Floor drain
Water piping
Water softener)
Water heater
Lavatory(basin)r
Gas sys up to 4 outletsF_
Gas sys # of outlets over 4)
Backflow device up to 2":r-
Backf ow device over 2":r—
RegulatorsF_
Lawn Sprinkler System:r
Roof drains
Hose bibbF—
Drinking fountain.F—
Grease trap)
Grease interceptor:r
P-trap
Sewer
New sewer
Sewer alter/repair)—
Sewer abandonmentr—