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Home My WebLink AboutX2021-2533 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application P[int,Form: o� m City of Newport Beach ZaZ I z Building Division Z(C(3 1. Project Address INot mailing address) Buildn Permit No. I_ _ (D / w sZ1Ntj+..IZ �14L.� (�N o7 U. _ Floor �— Suite F_ 2.Ownees Name \\ Last -T L,ti.�� First Mik.aC�� Owner's Street Address 170% ��'�`'r LLs $Sl City State Zip Telephone r� j�hY0 Owner's E-mail Address r 3. Applicant's Name Last jw 1 I'— I First Applic nt's Street Ad ress City State Zip 1:03 Telephone r- � Applicant's E-mail Address JAA r. I— 4. Contractor's Name Last v First I ^' State Lic # Contractor's Street Address FJ k - City State Zip (, J Telephone F_ Contractor's E-mail Address Business Lic # F Mechanical Furnace Quantity up to 100,000 btu over 100,000 btul wall/floor heaters Heat Pumps/Package Units up to 100,000 btu) — up to 1,000,000 btul— up to 1, 750,000 btuF > 1, 750,000 btu)— Boilers/Compressors up to 3 HP) 3 HP-15 HPr 15 HP-30 HPr- 30 HP-50 HPr >50 HPI— Air Handling Units up to 10,000 CFM� > 10,000 CFMI— VAV Boxl Repair/Alter/Add HVAC Number of Zones) — Ventilation Bathroom Fanl— Exhaust Fanl— Attic Exhaust Residential HoodF_ Commercial Hood Metal FireplaceF_ Gas Line Fire DampersF— Electrical Plumbing New Construction Quantity Bathroom Quantity Quantity 1 & 2 Family S.FF— Multi Family S.F) Receptacle, Switch Lighting Outlets Total Outlets Lighting Fixtures Total Fixturesf— Total Low Voltage Separate Circuity Motors/Transformers 0-1 HP or KVAI 1-10 HP or KVAI 10-50 HP or KVAI 50-100 HP or KVAI Over 100 HP or KVAI Signs One branch circuitF— Add'I branch circuit:r— Service 0-600V not over 200A:r 0-600V& over 200A1 over 600V1 Temp PP/Piggy Back Sub Panel Other Water closet (toilet)F-- Bidet �— Urinal Bath Tubl Shower stall Lavatory (basin) Hydro -massage tubl, Kitchen Kitchen sink r Garbage Disposal F— Bar sink Vegetable sink Dishwasher Laundry/washing trap Ice makerr— Floor sink) Miscellaneous Floor drain Water piping Water softeners Water heater Lavatory (basin)F-- Gas sys up to 4 outlets) Gas sys # of outlets over 4l— Backflow device up to 2"I Backflow device over 2") Regulators Lawn Sprinkler System Roof drains Hose bibbl Drinking fountain Grease trap Grease interceptor P-trapF— Sewer New sewer Sewer alter/repair Sewer abandonment