HomeMy WebLinkAboutM2022-0059 - Permit Application (3)Print Form Worksheet for Combo Building & Solar Permit Application Sr F_Comm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
rBuilding JGrading r-Drainage (XElec r,Mech [Plum cuYdcut7,400 cuYdFill IV
Project Address (Not mailing address) F Flood rX Fire r- Liq r; Landslide [_N/A Floor Suite No
201 East Coast Highway, Newport Beach, CA 92660 N/A N/A
Description of Work
Use Private ConstType General
Installation of bulkhead wall improvements, construction of floating
docks, installation of piles,
# Stories # Units (if Res)F_
utility systems, waterside dredging, and construction of rock slope protection.
Valuation $
Material/Labor $6,496,000
New/Add SF +8,805 SF -Dock Remodel SF N/A
Garage/New/Add N/A
_ -
OWNER'S NAME Last The Irvine Company
First CRC Marinas
Owner's Address
Owner's E-mail Address
550 Newport Center Drive
- - -
gsinks@irvinecompany.com
_
City Newport Beach State CA Zip 92660 Telephone 949-720-3408
APPLICANT'S NAME Last City of Newport Beach (Sub -Applicant) First I Contact - Chris Miller
Applicant's Address
Applicant's E-mail Address
City of Newport Beach - 100 Civic Center Drive
CMiller@newportbeachca.gov
City Newport Beach State CA
Zip F92660 Telephone 949-644-3043
ARCHITECT/DESIGNER'S NAME Last N/A
FirstF Lic. No. �—
ArchitectlDesigner's Address
Architect/Designer's E-mail Address
City I State I
Zip �— Telephoned-;
ENGINEER'S NAME Last Holcomb
First Jeremiah Lic No. 880027
Engineer's Address
Engineer's E-mail Address
4225 E. Conant St.
iholcomb@moffattnichol.com
city Long Beach State CA
Zip 90808 Telephone 562-590-6500
CONTRACTOR'S NAME/COMPANY TBD
Lic. NoT - Class F
Contractor's Address
Contractors E-mail Address
City State F—
Zip F— Telephoned—
q 2
O l J
SETBACKS REAR SETBACKS FRONT
PERMIT NO. NSW ✓Ci —�
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO.
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES$
�) (2,Ze Z, - - 0Z<�S
Print Form Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailingaddress) Building Permit No.
East Coast Highway, Newport Beach, CA 92660
Floor N/A Suite N/A
4l+EWepNT
2. Owner's Name Last The Irvine Company
First CRC Marinas
Owner's Street Address - -
- - --
550NewportCenter Drive
City Newport Beach -
�
State FCA
Zip 92660
Telephone 949-72073408 _ - _' Owner's E-mail Address
gsinksLam inecompany.com
r, 3. Applicant's Name Last (Owners Engineer) -Holcomb'.
First Jeremiah
A licant's Street Address
422SE. Conant St.
City .Long Beach
State CA
Zip 90808
Telephone 562-590-6500 Applicant's E-mail Address jholcomb@moffattnichol.com
F_ 4. Contractor's Name Last TBD First
State Lic #
Contractor's Street Address
City F-- State F_ Zip �—
Telephone—; Contractor's E-mail Address I Business Lic# F—',
Mechanical
Furnace Quantity
Electrical
New Construction Quantity
Plumbing
Bathroom Quantity Quantity
up to 100,000 btuE—
1&2 Family S.Fs—
Water closet(toilet)s— Backflow device up to 2":_—'
over 100,000 btu:—
Multi Family S.F:s--
Bidets— Backflow device over 2"s—
wall/floorheaters:s—
Receptacle, Switch Lighting Outlets
Urinals— Regulators:s—
Heat Pumps/Package Units
up to 100,000 btu—
Total Outlets:27
Bath TubF_ Lawn Sprinkler System:_
up to 1,000,000 btus—
Lighting Fixtures
Shower stalls— Roofdrains:s—
up to 1, 750,OOO btus—
Total Fixtures:
:— _
Lavatory (basin)Hose bibb: 27_
> 1, 750,000 btus—
Total Low Voltages —
Hydro -massage tu6:s— Drinking fountain:s—
Bailers/Compressors
up to 3 HP:�--
Separate Circuit: sl-
Kitchen
Kitchen sink Grease
—Grease interceptor:
3 HP-15 HP: L
Motors/Transformers
Garbage DBpos Is
P-tra
15 HP-30 HPs-
0-1 HP or KVA:s—
Bar sink Sewer
30 HP-50 HPs
1-10 HP or KVAs—
- - —
Vegetable sink: New sewe
- ----
>50 HPs--
10-50 HP or KVA1
--
Dishwashers— Sewer alter/repair...
Air Handling Units
50-100 HPor KVA:
Laundry/washing trap Sewer abandonments--
up to 10,000 CFMs—
Over 100 HP or KVA:s—
Ice makers—
> 10,000 CFMs—
Signs
Floor sinks—
VAVBox:s--
One branch circuit:s--
Miscellaneous
Repair/Alter/Add HVAC
Add'I branch circuit: --
Floordrainr—
Number of Zones—
i
Service
Water piping
Ventilation
Bathroom Fans--
0-600V not over 200As—
WWater fteners-
I �—
Exhaust Fan i..
0-600V & over 200A:s1
—
C�
Ovate F �p'S 1
Attic ExhausTs--s—
over 600Vs—
Temp PP/Piggy Backs --
Lavatory(basin)
Residential Hood:s—
SubPanel:s3 —
Gas sys up to4outlets s—
Commercial Haod:s—
--
Others--
Gas sys # of outlets over 4:s—
Metal Fireplaces
Gas Lines—
_
Fire Dampers�—
Worksheet for Combo Building & Solar Permit Application
r Residential City of Newport Beach - Building Division
NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
.ding rGrading (—Drainage rElec r, Mech rPlum Cu Yd cut 7,400 Cu Yd Fill lu
.oject Address (Not mailing address) r Flood r Fire r Liq [ Landslide rN/A Floor Suite No
Newport Beach, CA 92660 N/A N/A
G01 East Coast Highway,
Description of Work
Use Private ConstType General
Installation of bulkhead wall improvements, construction of floating docks, installation of piles,
# Stories #Units (if Res)
Utility systems, waterside dredging, and construction of rock slope protection.
Valuation $
New/Add SF +8,805 SF -Dock Remodel SF N/A Garage/New/Add N/A
Material/Labor F$6496,000
OWNER'S NAME Last The Irvine Company First CRC Marinas
Owner's Address Owner's E-mail Address
550 Newport Center Drive gsinks@irvinecompany.com
City New ort Beach State CA
y p Zip 92660 Telephone 949-720-3408
APPLICANT'S NAME Last City of Newport Beach (Sub -Applicant) I'_ First I Contact - Chris Miller
Applicant's Address Applicant's E-mail Address
City of Newport Beach - 100 Civic Center Drive Chiller@newportbeachca.gov
City Newport Beach State CA Zip f92660 Telephone 949-644-3043
ARCHITECT/DESIGNER'S NAME Last N/A First F Lic. No. �—
Architect/Designer's Address Architect/Designer's E-mail Address
City I State F_ Zip I Telephoned
ENGINEER'S NAME Last Holcomb First Jeremiah Lic. No. C80027
Engineer's Address Engineer's E-mail Address
4225 E. Conant St. jholcomb@moffattnichol.com
City Long Beach State CA Zip 90808 Telephone 5 22-590-65�00
CONTRACTOR'S NAME/COMPANY
✓l Lic. No. F-Xj i2 Class
Contractor's Address Contracto' E-mail Address
n
E 501 V4 ki"J ski S ��� 2 7tg h l /owti. -f
l2t [�(c�✓I. GF7
City Rg"IC„/� State � Zip �/�rJ'�/ Telephone
�c I / A2
— 0
CI,k'r�,
SETBACKS REAR SETBACKS FRONT PERMIT NO. — (SUWS 6j
\ SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. C WIi�
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
Print Form Worksheet for Electrical/Mechanical/ Plumbing Application
— — City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
East Coast Highway, Newport Beach, CA 92660
Floor N/A Suite N/A
r 2.owner's Name Last IThe Irvine Company First CRCMarinas
Owner's Street Address -- _ _-- -- - --
550Newport Center Drive City Newport Beach_ State W` Zip 92660
Telephone 949-720-3408 Owner's E-mail Address gsinks@iwinecompany.com
r. 3. Applicant's Name Last ](Owners Engineer) - Holcomb First Jeremiah
A licant's Street Address - -
4225 E.Conant St. City Long Beach State F Zip 90808
Telephone 562-590-6500 Applicant's E-mail Address jholcomb@moffattnichol.com
r'. 4. Contractor's Name Last
Contractor's Street Address
Telephone
Mechanical
Furnace Quantity
up to 100,000 btu:r—
over 100,000 btu
:�—
wall/Floor heatersr-
Heat Pumps/Package Units
up to 100,000 btur-
up to 1,000,000 btu:F-
up to 1, 750,000 btu:r—
> 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
Air Handling Units
up to 10,000 CFMr—
> 10,000 CFM:r—
VAV Box:r—
Repair/Alter/Add HVAC
Number ofZones:r—
Ventilation
Bathroom Fanr-
Exhaust Fan:r--
Attic Exhaust:_ --
Residential Hood
Commercial Hood
Metal Fireplace:r_
Gas Linef -
Fire Dampers:_ --
Contractor's E-mail Address
a
First I State Lic #
City F—State F_ Zip F—
Business Lic# r--
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F:F—
Multi Family S.F:r—
Receptacle, Switch Lighting outlets
Total Outlets: 27
Lighting Fixtures
Total Fixtures:r—
Total LowVoltage:[--
Separate Circuit:r—
Motors/Transformers
0-1 HP or KVA:F—
1-10 HP or KVA:r-
10-50 HP or KVA: 1 -
50-100 HPorKVA:r—
Over 100 HP or KVA:r—
Signs
One branch circuits --
Add'I branch circuitor—
Service
0-600V not over 20OA:r-
0-600V & over 200AF
over 600Vr
Temp PP/Piggy Back:r—
Sub Panel:_--
Other:r—
Water closet (toilet)_
Bidet
Urinal �—
Bath Tubr-
Shower stall:__
Lavatory (basin):_
Hydra -massage tub:r—
Kitchen
Kitchen sink
Garbage Disposalr—
Bar sinks
Vegetable sink:r—
Dishwasher
Laundry/washing trapr—
Ice maker
Floor sinkr-
Miscellaneous
Floor drainr—
Water pipings
Water softenerf--
Water heaterr—
Lavatory(basin)r
Gas sys up to 4 outlets[ —
Gas sys 4 of outlets over 4r
Backflow device up to 2":F
Backflow device over 2":r—
Regulators:r—
Lawn Sprinkler System:F—
Roofdrains:r—
Hose bibb: 27
Drinking fountain:-
Greasetrap:r—
Greaseinterceptor. --
P-trap:_
Sewer
New sewer_—'
Sewer alter/repair:r—
Sewer abandonment:r—
Print Fofm Worksheet for Combo Building & Solar Permit Application
r Comm'I City of Newport Beach - Building Division
j Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL
Q
rBuilding GC Grading rDrainage r Elec r Mech r Plum Cu Yd cut 7,400 Cu Yd Fill I
Project Address (Not mailing address) F Flood [ Fire r Liq r Landslide F_N/A Floor Suite No
201 East Coast Highway, Newport Beach, CA 92660 N/A N/A
Description of Work
Use Private Const Type General
Installation of bulkhead wall improvements, construction offloating
docks, installation of piles,
- -
# StoriesF # Units (if Res)[
utility systems, waterside dredging, and construction of rock slope protection.
Valuation $
Material/LaborF$6496,000
New/Add SF +8805 SF -Dock Remodel SF N/A
Garage/New/Add N/A
- -
— _'.
OWNER'S NAME Last The Irvine Company
First CRC Marinas
Owner's Address
Owner's E-mail Address
550 Newport Center Drive
— —
gsinks@irvinecompany.com
City Newport Beach State CA Zip 92660 �i Telephone 949-720-3408
-- - - -
APPLICANT'S NAME Last CiTy of Newport Beach (Sub -Applicant) First Contact - Chris Miller
Applicant's Address
Applicant's E-mail Address
City of Newport Beach - 100 Civic Center Drive
CMiller@newportbeachca.gov
City I Newport Beach State CA
Zip F92660 Telephone 949-644-3043
ARCHITECT/DESIGNER'S NAME Last N/A
First F. Lic. No. F_.
Architect/Designer's Address
Architect/Designees E-mail Address
City State I
—
Zip I Telephone
ENGINEER'S NAME Last Holcomb
First Jeremiah Lic. No. C80027.
Engineer's Address
Engineer's E-mail Address
4225 E. Conant St.
jholcomb@moffattnichol.com
City Long Beach State CA
Zip 90808 Telephone 562-590-6500
CONTRACTOR'S NAME/COMPANY TBD
Lic. No. F_— Class
Contractor's Address
Contractor's E-mail Address
City State F_
Zip F Telephoner
q ?
Q t J
SETBACKS REAR SETBACKS FRONT
PERMIT NO.
SETBACKS LEFT SETBACKS RIGHT
PLAN CHECK NO. �C. Zt'J]iZ 31
USE ZONE DEVELOPMENT NO
PLAN CHECK FEES $
('( C/ - DZSS
Print Form Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
East Coast Highway, Newport Beach, CA 92660
r 2.Ownees Name Last The Irvine Company
Owner's Street Address - - - --
Floor N/A _ Suite N/A
First CRCMarinas
550 New port Center Drive City Newport Beach. State FCA Zip 92660
Telephone I949-720-3408 _ Owner's E-mail Address Igsinks@irvinecompany.com
F. 3. Applicant's Name Last (Owners Engineer) -Holcomb - First Jeremiah
A licant's Street Address - -- r
4225E. Conant St. City Long Beach State I� Zip 90808
Telephone 562-590-6500 Applicant's E-mail Address jholcomb@moffattnichol.c'om
F'. 4. Contractor's Name Last
Contractor's Street Address
Telephone
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 btu:: —
up to 1, 750,000 btu:F—
> 1, 750,000 btu:r—
Boilers/Compressors
up to 3 HP:r
3 HP-15 HP::
15 HP-30 HPF
30 HP-50 HP:—
>50 HP:: —
Air Handling Units
upto 10,000 CFM:—
> 10,000 CFM::—
VAV Boxf—
Repair/Alter/Add HVAC
Number of Zones:—
Ventilation
Bathroom Fan: —
Exhaust FanF—
Attic Exhaust:: —
Residential Hood
Commercial Hood: —
Metal Fireplace: —
Gas Line:: —
Fire Dampers:: —
city
Contractor's E-mail Address
First
State Lic# I —
State F_ Zip
Business Lic# I
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1&2 Family S.Ff —
Multi Family S.F:r—
Receptacle, Switch Lighting Outlets
Total Outlets: 27
Lighting Fixtures
Total Fixtures:[8--
Total Low Voltage:: —
Separate Circuit:
Motors/Transformers
0-1 HP or KVA:r-
1-10 HP or KVA::-
10-50 HP or KVA:
50-100 HPorKVA:r—
Over 100 HIP orKVA:F—
Signs
One branch circuit::—
Add'I branch circuit:r—
Service
0-600V not over 200A:—
0-600V & over 200A:FI—
over 600VF_
Temp PP/Piggy Back:r—
Sub Panel:F—
Other:e_
Water closet(toilet):
Bidet:
Urinal :F_—
Bath Tub:
Showerstall:
Lavatory (basin):
Hydro-massagetub:
Kitchen
Kitchen sink �—
Garbage Disposal:
Bar sink:
Vegetable sink::
Dishwasherf--
Laundry/washing trap:
Ice maker:
Floorsink:—
Miscellaneous
Floor drain:
Water piping :—
WatersoftenerF—
Waterheater:
Lavatory (basin):
Gas Sys up to 4 outlets:
Gas sys # of outlets over 4:
Backflow, device up to 2"a�—_'
Backflow device over 2":I
Lawn
Drinking fountain:
Grease trapi
Grease interceptor:
P-trapf —
Sewer
New sewer:
Sewer alter/repair.
Sewer abandonment:
Print Form
Please print 3 copies
Associated Building Permit #
Worksheet for Fire Permit Application
City of Newport Beach - Building Division
1. Project Address (Not mailing address)
r Fire Sprinkler r7 Fire Alarm r Fire Misc
1201 East Coast Highway, Newport Beach, CA 92660
Tenant Name The Irvine Company / CRC Marinas
2. Description of Work
Installation of bulkhead wall improvements, construction of floating docks, installation of
piles, utility systems, waterside dredging, and construction of rock slope protection.
Extg Sq Ft 21,700 SF -Dock New/Added Sq Ft +8,805 SF -Dock Total Sq Ft 30,505 SF -Dock
- - - -
F_ New r Add F7 Alter (-- Demo
unecK Appropriate Box for ApplicanVNotification
Floor Suite No
N/A
# Units N/A
Use (Private
Valuation $ $6,496,000
# Stories F1
[, 3. Owner's Name
Last The Irvine Company
First FCRC Marinas
Owners Address
Owner's E-mail Address
550 Newport Center Drive
_-
sinks
g @irvinecompany.com
City Newport Beach
State CA
Zip 92660 Telephone 949-720-3408
r 4. Architect/Designer's Name Last N/A First F— Lic. No. �—
ArchitectlDesigners Address
Architect/Designers E-mail Address
City - _ --_
', State �—
Zip F_ Telephone—
[5. Engineer's Name
Last Holcomb -
First Jeremiah Lic. No. C80027
Engineer's Address
Engineers E-mail Address
4225 E. Conant St.
jholcomb@moffattnichol.com
City Long Beach
State CA
Zip 90808 Telephone 562-590-6500
F 6. Contractor's Name Last
TBD
First Lic No. �— Class —.
Contractors Address
Contractor's E-mail Address
City
State F—..
Zip F— Telephone[
OFFICE USE ONLY
PERMIT NO.
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
Print FoE71 Worksheet for Combo Building & Solar Permit Application
Comm'I City of Newport Beach - Building Division
r Residential NOTE: PLAN CHECK FEES DUE AT TIME OF SUBMITTAL oc'
o nN
rBuilding r, Grading rDrainage r Elec r. Mech r Plum Cu Yd Cut 7,400 Cu Yd Fill Ip
Project Address (Not mailing address) F Flood r Fire r Liq r Landslide rN/A Floor Suite No
201 East Coast Highway, Newport Beach, CA 92660 N/A N/A
Description of Work
Use Private ConstType General
Installation of bulkhead wall improvements, construction of floating docks, installation of piles,
# StoriesF- # Units (if Res)F
utility systems, waterside dredging, and construction of rock slope protection.
-- .
Valuation $
Material/Labor 96,496,000
New/Add SF +8 805 SF -Dock Remodel SF N/A _ Garage/New/Add N/A
OWNER'S NAME Last The Irvine Company First CRC Marinas -
Owner's Address Owner's E-mail Address
550 Newport Center Drive gsinks@irvinecompany.com
City Newport Beach State CA Zip 92660_-J Telephone 949-720-3408
APPLICANT'S NAME Last City of Newport Beach (Sub -Applicant) First Contact - Chris Miller
Applicant's Address Applicant's E-mail Address
City of Newport Beach - 100 Civic Center DriveCMiller@newportbeachca.gov
r-- — _
City Newport Beach State CA Zip 92660 Telephone 949-644-3043
ARCHITECT/DESIGNER'S NAME Last N/A First
Lic. No. F_'
Architect/Designer's Address ArchitecUDesigners E-mail Address
City State �— Zip [ Telephoned—',
ENGINEER'S NAME Last Holcomb First Jeremiah Lic. No. 880027
Engineer's Address Engineers E-mail Address
4225 E. Conant St. jholcomb@moffattnichol.com
City Long Beach State CA Zip 90808 Telephone 562-590-6500
CONTRACTOR'S NAME/COMPANY _TBD Lic. No. F_ Class F—
Contractor's Address Contractors E-mail Address
City State 7— Zip �— Telephoned
SETBACKS REAR SETBACKS FRONT PERMIT NO. NSWt� z z_ _
SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO.
USE ZONE DEVELOPMENT NO PLAN CHECK FEES $
0z z rL 2 - C) z< -S
Worksheet for Fire Permit Application
o��o�•"e Print Form City of Newport Beach - Building Division
Please print 3 copies G r„
Associated Building Permit# r Fire Sprinkler F Fire Alarm r Fire Misc
1. Project Address (Not mailin
1201 East Coast Highway, Newport Beach, CA 92660
Tenant Name The Irvine Company ! CRC Marinas
2. Description of Work
Installation of bulkhead wall improvements, construction of floating docks, installation of
piles, utility systems, waterside dredging, and construction of rock slope protection.
Extg Sq Ft 21,700 SF -Dock New/Added Sq Ft +8,805 SF -Dock Total Sq Ft 30,505 SF -Dock
r New r Add r. Alter rl Demo
�IrrcR r PprUprrate oox You Hppucanunotlrication
Floor Suite No
N/A N/A
# Units N/A
Use Private
Valuation $ $6,496,000
# Stories I
FX_ 3. Owner's Name Last The Irvine Company
First CRC Marinas
Owner's Address
Owners E-mail Address
550 Newport Center Drive
_
sinks
g @irvinecompany.com
City Newport Beach State
CA
Zip 92660 Telephone 949-720-3408
4. Architect/Designer's Name Last N/A
First F— Lic. No. �—
Architect/Designers Address
Architect/Designer's E-mail Address
City - - - -- - _ State
F—
ZiP F— Telephone—
5. Engineer's Name Last Holcomb
First Jeremiah
- . _ Lic. No. C80027
Engineer's Address
Engineer's E-mail Address
4225 E. Conant St.
jholcomb@moffattnichol.com
City Long Beach State
CA
Zip 90808 Telephone 562-590-6500
r 6. Contractor's Name Last TBD
First F— Lic. No. F— Class —.
Contractors Address
Contractor's E-mail Address
City State
F—
Zip [— Telephone
OFFICE USE ONLY
PERMIT NO. -
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
PLAN CHECK FEE $
Print Form Worksheet for Electrical/Mechanical/ Plumbing Application �EWP°RT
-- City of Newport Beach
Building Division
G , ears
1. Project Address (Not mailing address) Building Permit No.
1201 East Coast Highway, Newport Beach, CA 92660
Floor N/A Suite
2.Ownees Name
Last The Irvine Company
First CBC Marinas
.N/A
Owner's Street Address
_ _P_ _Y
_--
550 Newport Center Drive
_ City Newport Beach _ State CA
Zip 92660
Telephone 949-720-3408
Owner's E-mail Address
gsinks@iwinecompany.com
r. 3. Applicant's Name
Las[ (Owners Engineer) - Holcomb
First Jeremiah
licanLs Street Address
rA
4225 E. Conant St.
City Long Beach State CA
Zip 90808
Telephone 562-590-6500
Applicant's E-mail Address
iholcomb@moffattnichol.com
r: 4. Contractor's Name Last
Contractor's Street Address
Telephone 7—
Contractor's E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btur—
over 100,000 btu:r—
wall/Floor heaters:r—
Heat Pumps/Package Units
up to 100,000 btu:r
up to 1,000,000 btu:r--
up to 1, 750,000 btu:r
> 1, 750,000 btu:r—
Boilers/Compressors
up to 3 HP:r-
3 HP-15 HP:r--
15 HP-30 HP[
30 HP-50 HP:r—
>50 HP:r—
Air Handling Units
upto 10,000 CFMF
> 10,000 CFM:r—
VAV Box:r—
Repair/Alter/Add HVAC
Number of Zones:r—
Ventilation
Bathroom ran[ --
Exhaust Fang_
Attic Exhaust :r—
Residential Hood-.1—
Commercial Hood:r--
Metal Fireplacer—
Gas Liner --
Fire Dampers:r—
—
First
City
State Lic # I —
State I— Zip F—
Business Lic# r-
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 family S.F:F7_
Multi Family S.F f —
Receptacle, Switch Lighting Outlets
Total Outlets: 27
Lighting Fixtures
Total Fixtures
Total Low Voltage
Separate Circuit: r—
Motors/'ransformers
0-1 HP or KVA:r-
1-10 HP or KVA:r-
10-50 HPorKVA.F-
50-100 HPorKVA:r—
Over 100 HP or KVA:r—
Signs
One branch circuit:r—
Add'I branch circuit
Service
0-600V not over 200Ar-
0-600V & over 200A:F
over 600VF_
Temp PP/Piggy Back:r--
Sub Panel:r3
Other:r—
Water closet (toilet)r—
Bidet
urinal F_
Bath TubF_
Shower stall:r--
Lavatory(basin):r—
Hydro-massage tub
Kitchen
Kitchen sink �—
Garbage Disposal:r--
Bar sink
Vegetable sink--
Dishwasherr—
Laundry/washing trap
Ice maker f —
Floor sink:r—
Miscellaneous
Floordrainr—
Water piping
Watersoftenerl—
Water heaterF—
Lavatory (basin):r—
Gas sys up to 4 outlets:r—
Gas sys # of outlets over 4�—
Backflow device up to 2":r
Backflow device over 2":r—
Regulators:: --
Lawn Sprinkler System:r—
Roofdrains:r--
Hose Bibb: 27
Drinking fountain:r—
Grease trap f —
Greaseinterceptor:r—
P-trap{—
Sewer
NewsewerF_
Sewer alter/repaid
Sewer abandonmentF—
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