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
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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—
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