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HomeMy WebLinkAboutXC2023-0029 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application Print Form City of Newport Beach Building Division 1. Project Address (Not mailing address) Building Permit No. c'Zo Z 3 ooZ q Newport Center Drive, Newport Beach Iln ( Floor Suite r 2. Owner's Name Last Joe First woldenberg Owner's Street Address 401 Newport Center Drive city Newport Beach State CA Zip 92660 Telephone 949.720-3300 Owner's E-mail Address jwoldenberg@iwinecompany.com r 3. Applicant's Name Last Breck First James A licant's Street Address 3187 Airway Ave. Bldg C City Costa Mesa State CA Zip 92626 Telephone 949.368.3003 Applicant's E-mail Address jbreck@pbsengineers.com r4. Contractor's Name Last I _ P'r 0A,/..E0A( First NIR-'j'"H fj-/�J State Lic # F p j ? 8i( L Contractor's Street Address /� ii ���i ,�7j00 ?0-7 %. . 2y 1 S% SS "C2AiLS 16 C Q 2 city OLP %I Vok State � Zip !�gg,7 ,Telephone +i/f./ . -M .77`P Contractor's E-mail Address N W91l-�-A � QM j-0 � $T'( 0ep,*�Business Lic# Flj-r 3pO6 o-7tlr / M- Mechanical Furnace Quantity up to 100,000 btu:1 over 100,000 btu:r— wall/floor heaters Heat Pumps/Package Units up to 100,000 btu :r— up to 1,000,000 btur— up to 1, 750,000 btuF -- > 1, 750,000 btu:r— Boilers/Compressors up to 3 HP:r- 3 HP-15 HP:r- 15 HP-30 HPr- 30 HP-50 HP:r_ >50 HP•.r— Air Handling Units up to 10,000 CFMr > 10,000 CFM:r— VAV Box:r— Repair/Alter/Add HVAC Number of Zones Ventilation Bathroom Fanf — Exhaust Fares_ Attic ExhaustF Residential Hood:r— Commercial Hood :r— Metal Fireplace:r— Gas Line:F— Fire Dampers:ri Electrical New Construction Quantity 1 & 2 Family S.Fr Multi Family S.F:r— Receptacle, Switch Lighting Outlets Total Outlets Lighting Fixtures Total Fixtures:r— Total Low Voltage:r— Separate Circuit:ri Motorsrrransformers 0-1 HP or KVA.r- 1-10 HP or KVAF_ 10-50 HP or KVAF_ 50-100 HP or KVAF_ Over 100 HP or KVAF_ Signs One branch circuit Add'I branch circuitF— Service 0-600V not over 200Ar 0-600V & over 200A:r— over 600Vr Temp PP/Piggy Back Sub Panelr— Otherr— Bathroom Quantity Water closet (toilet):r— Bidet:r— Urinal r Bath Tub:r— Shower stall:r— Lavatory (basin):r— Hydro-massage tube Kitchen Kitchen sink :r— Garbage Disposal:r— Bar sink Vegetable sinks Dishwasher Laundry/washing traps Ice maker:r— Floor sinks Miscellaneous Floor drains Water piping Water softener[ Water heater:r— Lavatory (basin)r Gas sys up to 4 outlets:r— Gas sys # of outlets over 4:r— Plumbing Quantity Backflow device up to 2":r- Backflow device over 2":r- Regulators:r— Lawn Sprinkler System Roof drains :r— Hose bibb:r— Drinking fountain:r— Grease trapr— Grease interceptorr P-trap:r— Sewer New sewer:r— Sewer alter/repair:r— Sewer abandonment:r— S,� XGUrZZ> - c,41�z61 -0 l�-( �J\ S / C)00 W ! 4e l�