HomeMy WebLinkAboutP2019-0196 - Permit Applicationprint Form Worksheet for Electrical/Mechanical/ Plumbing Application ��Ewpm, Z
City of Newport Beach
Building Division °
1. Project Address (Not mailing address) Building Permit No. Paom-oiC1_co
- _ —. _ _ _- Floor F� Suite FI
2. Owner's Name Last !i First
Owners Street Address _-- - - :- I� -- �.�
City I •. State F Zip
Telephone 17�— Owners E-mail Address
PP Last ._...
3.A Iicanfs Name _-_ _... � First
A licant's Street Address
City State F Zip F—,'
Telephone Applicant's E-mail Address
F_ 4. Contractor's Name Last ! First State Lic4 F
Contractor's Street Address
City F�'State Zip F�,
Telephone Contractor's E-mail Address ; Business Uc if
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 btuF_—,
up to 1, 750,000 btu:--
> 1, 750,000 btu:r-
Boilers/Compressors
up to 3 HP:1_
3 HP-15 HP.F
15 HP-30 HP[
30 HP-50 HRT_.
>50 HP:F_
Air Handling Units
up to 10,000 CFM:F—,
> 10,000 CFMT_
VAV Box:—�
Repair/Alter/Add HVAC
Number of Zones:
Ventilation
Bathroom Fan:
Exhaust Fan:
Attic Exhaust::
Residential Hood::
Commercial Hood:
Metal Fireplace:F—
Gas Line:F—
Fire Dampers:: —
Electrical
New Construction Quantity.
1 & 2 Family S.F f —
Multi Family S.FF _
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total Fixtures
Total Low Voltage
Separate Circuit
Motors/Transformers
0-1 HP or KVA:
1-10 HP or KVAf—
10-50 HP or KVA:
50-100 HP or KVA:
Over 100 HP or KVA::
Signs
One branch circuit:F_
Add'I branch circuit:F--
Service
0-600V not over 200A::
0lOOV& over 200A:F_
over 600V�_
Temp PP/Piggy Back
Sub Panel:
Other
Bathroom Quantity
Plumbing
Quantity
Water closet (toilet) f 77
Backflow device up to 2 f __
Bidet:
Backfldw device over 2":
Urinal.i,
Regulators:—
BathTub:F
Lawn Sprinkler 5ystem:F_—•..
Shower stall f—
Roof drains:—'.
_ Lavatory (basin) f —�
Hose bibbF7
Hydro -massage tub:r Drinking fountain:F_
Kitchen
Kitchen sink F-7�
Garbage Disposal
Barsink:'
Vegetable sink;
Dishwasher—
Laundry/washing trap—'
Ice maker:
Floorsink,
Miscellaneous
Floor drain::
Water piping::
Water softener:
Water heater.
Lavatory (basin):—.
Gas Sys up to 4 outlets:1—
Gas Sys a of outlets over 4:r1 1
Grease trap:
Grease interceptor.:
P-trap:
Sewer
New sewer.'
Sewer alter/repair.
Sewer abandonmenk