HomeMy WebLinkAboutXR2023-0677 - Permit Application�.. i rrrrnrr j Epp orksheet for ColnboBuilding & Solar Permit Application Qg,.�Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Building Grading "Drainage Elec � ech /
-- �r<IUm Cu Yd Cuts Cu Yd Fill
Project Address (Not mailing address) F Flood r Fire F Liq F _ Landslide FAA Floor
Suite No
Description of Work
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fr be^,vl S ,
C A r3 r yr s # Stories # Units (if Res)s ) �--a-o-L
New/Add SFS Remodel SFS-
1 6 (? Garage/New/Add �- Valuation $
- Material/Labor
-
OWNER'S NAME -
Last First KYZ t S 7 L�-1 _
Owner's Address
Owner's E-mail Address
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city JAI .
s /t'Or�'7.() � ClState _ CAzip ��CiCTlpeI
APPLICANT'SNAME Last t1
_l First ��
Applicant's Address -_
3 Applicant's E-mail Address
Y y L A Ph L,,vi-,, y Q r-
i C'ctr�
City State (T Zip ct::gz,T Telephoner
ARCHITECT/DESIGNER'S NAME
Last P.J I S @ ,>J
Architect/Designer's Address
-LgSE• G 1�1(cwtJ
aw!jY LAND
City 151L LQ s 0 C K State Cyr
First1,1)1OL q S Lic. No. C,35
Architect/Designees E-mail Address
YtCl0.SW115r'v,
Zip 4aC ,2 gF Telephone
ENGINEER'S NAME Last
First Lic No.F�
Engineer's Address
�® Engineer's E-mail Address
City I State r'
Zip F- Telephone
CONTRACTOR'S NAME/COMPANY
;c PC %S �� (/1 Lic No. FYI) J � �� Class
Contractor's Address
Contractor's E-mail Address
-
F} v •�s t (r �1 State Zip 0 p
7= Telephone y/�j /E
SETBACKS REAR SETBACKS FRONT
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DEVELOPMENT NO
PERMIT NO. 77
PLAN CHECK N0.C��>
PLAN CHECK FEES $
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Pnnt Form - City of Newport Beach
Building Division U - ',
1. Project Address(Not mailing address) Building Permit No, I X K.0 oa.3 - 66 i7
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F1.Ve iiS.PA-��O(LT aRCkcC� - Floor F_ Suite-�.---_
[_ 2. Owner's Name Last T i c=!t W L �'
First
Owner's Street Address
City �IKk Po state
C_K
zip ll io p
ZOO L��C�Zws0. 1fA�sr4^
Telephone l(`vv �f`�, wner's E-mail Address
F_ 3. Applicant's Name Last
�St-�
First
A licant's Street Address
city ^ _ ; State
y v rw
c
Zip q ^' -_
L- 30 \ C R
- i�p1 � a �
Telephone \L't�(p(-t3 �j� : Applicant's E-mail Address
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f- 4. Contractor's Name Last
State Lick rj 3y($S
SLD
First (�' �-
Contractor's Street Address
-i3a1 �. CK-V-,SI V ,v _
City laV.AiI^ State
'}.4
Zip 92R0
Telephone ITt.A Contractor's E-mail Address ( �Cy( Z � Business Lick 't>T GG1i31oS2-
� c- P (-1- Co•M s —
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btu:
wall/floor heaters::
_Heat Pumps/Package Units
up to 100,000 btu:
up to 1,000,000 btu::_
up to 1, 750,000 btuF
> 1, 750,000 btu:
Boilers/Compressors
up to 3 HPr_
3 HP-15 HP[
15 HP-30 HP:
30 HP-50 HP:
>50 HP:
Air Handling Units
up to 10,000 CFM:r—
> 10,000 CFM::
VAV Boxr
Repair/Alter/Add HVAC
Number of Zones:F—•
Ventilation
Bathroom Fan:r )
Exhaust Fan::
Attic Exhaust[ —
Residential HoocI
Commercial Hoodr��
Metal Fireplace-1
Gas Line: -
Fire Dampers
Electrical
New Construction Quantity
1 & 2 Family S.F:r—
Multi Family S.F::
Receptacle, Switch Lighting Outlets
Total Outlets:rT�
Lighting Fixtures
Total Fixtures: ) ✓J
Total Low Voltage:.
Separate Circuit:
Motors/Transformers
0-1 HP or KVA:1--
1-10 HP or KVA::—'
10-50 HP or KVA::'
50-100 HP or KVA:r—
Over 100 HP or KVA::
Signs
One branch circuit:
Add'I branch circuit:r—
Service
0-600V not over 200A::
0-600V & over 2004
over 600V::-
Temp PP/Piggy Back:r—
Sub Panel:_
Other: -
Plumbing
Bathroom Quantity Quantity
Water closet (toi let):
Bidet
Urinal
Bath Tub f
Shower stall::
Lavatory (basin):
Hydro -massage tub::
Kitchen T
Kitchen sink:r /
Garbage Disposal::
Bar sink:
Vegetable sink:r—
Dishwasher
Laundry/washing trap::
Ice maker::
Floor sink::
Miscellaneous
Floor drain::
Water piping:
Water softener:r—
Water heater.:
Lavatory (basin):: -
Gas sys up to 4 outlets:r_
Gas sys kof outlets over 4:r—
Backflow device up to P' j
Backflow device over 2" .:
Regulators:[ —
Lawn Sprinkler System::
Roof drains:
Hose bibb::
Drinking fountain:
Greasetrapr—
Greaseinterceptor:
P-trap::
Sewer
New sewer.:
. ...........
Sewer alter/repair.)
Sewer abandonment: