HomeMy WebLinkAboutH2023-0530 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application
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City of Newport Beach z
Building Division a,
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1. Project Address (Not mailing address) Building Permit No.
Floor F— Suite
r 2. Owner's Name Last _q O n 7 First
Owner's Z/4
Street Address l�
D r1lP 4 G rl%Y• City I State r- Zip (—
Telephone 6' f -1 6 IO - -i % Owner's E-mail Address
r 3. Applicant's Name Last TQ 4✓ First
TSQR L
A licant's Street Address
142iz V�eV- "Dr• v city State 7_;{_ziP 9Z(oaq-
Telephone '7(q ']ZI-- 0I Applicant's E-mail Address _TC cr`S1 rieCr;-3 18 GJ Pypq/ .�O /s
I- 4. Contractor's Name Last -Z'8 First J State Lic # F—
Contractor's Street Address
City F— State F_ Zip
Telephone _—_ Contractor's E-mail Address I Business Lic# F _—
Mechanical
Furnace Quantity
up to 100,000 btu_ —
over 100,000 btu:s—
wall/Boor heaters
Heat Pumps/Package Units
up to 100,000 btu.F_
up to 1,000,000 btu:_ --
up to 1, 750,000 btu:_--
> 1, 750,000 btu:_--
Boilers/Compressors
up to 3 HP:r-
3 HP-15 HP:r--
15 HP-30 HPs
30 HP-50 HPF—
>50 HIP :_—
Air Handling Units
up to 10,000 CFM:r'
> 10,000 CFM:r--
VAV Box:_—
Repair/Alter/Add HVAC
Number of Zoness
Ventilation
Bathroom Fan.
Exhaust Fan
Attic Exhausts!
Residential Hood:_ —
Commercial Hood
Metal Fireplace (i
Gas Line._
Fire Dampers.,
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F:ri
Multi Family S.F:F--
Receptacle, Switch Lighting Outlets
Total Outlets: —
Lighting Fixtures
Total Fixtures:_ --
Total Low VoltageF—
Separate Circuit:_
Motors/Transformers
0-1 HP or KVA:_
1-10 HP or KVA:r-
10-50 HP or KVA.r
50-100 HP or KVA:r-
Over100 HPorKVA:_—
Signs
One branch circuit_—
Add9 branch circuitF—
Service
0-600V not over 200AF—
0-600V & over 200A._—
over 600V:s—
Temp PP/Piggy Back :_—
Sub Panels--
Other:F
Water closet (toilet):ri
Bidet:r—
Urinal :F_
Bath Tub:_ -
Shower stall r—
Lavatory (basin):r—
Hydro-massage tub_
Kitchen
Kitchen sink:_ —
Garbage Disposal: --
Bar sink:r—
Vegetable sink:ri
Dishwashers--
Laundry/washing trap F—
Ice maker:__
Floorsinkr
Miscellaneous
Floor drainf—
Water piping: —
Water softener
s—
Water heaters'
Lavatory (basin)_
Gas sys up to 4 outletsF_
Gas sys # of outlets over 4�_
BackBow device up to 2"1
BackBow device over
Regulators[
Lawn Sprinkler System:__
Roof drains:rs
Hose bibb:r-_
Drinking fountain:_
Grease trap:
Grease interceptor.F
P-trap: -
Sewer
New sewer:_—
Sewer alter/repair:_
Sewer a bandonment:,f_