HomeMy WebLinkAboutP2021-0515 - Permit Applicationprint Form Worksheet for Electrical/Mechanical/ Plumbing Application Po,
City of Newport Beach
Building Division it x
1. Project Address (Not mailing address)
Building Permit No.
60 l i_.. go qn Dr
Floor-- Suite �-
r 2.Owner's Name Last First
Owner's Street Address
CiTy F� State Zip F_
Telephone F� Owner's E-mail Address
Ap 3. Applicant's Name Last FTq, Irj Yl ,/ First K-( 01411
Applicant's Street Address t' 1 'T'
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Telephone C El N l - (y (1 _ 6ML Applicant's E-mail Address u
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r 4. contractor's Name Last f First �td �1 � State Lic N , I
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Contractor's Street Address V
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Telephone �G' qo I .- 9 2 Z _ � Ir'CLContractor's E-mail Address 1 G (A'EO 5C,t411-e P O1'V r (0 i'V\ Business LicW -{ 4 57 Z
Mechanical
Furnace Quantity
up to 100,000 btu f —
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:—
> 1, 750,000 btu:F-
Boilers/Compressors
up to 3 HP::-
3 HP-15 HP:F--
15 HP-30 HP:-
30 HP-50 HP::-
>50 HP:: -
Air Handling Units
up to 10,000 CFM::-
> 10,000 CFM f _
VAV Box:-
Repair/Alter/Add HVAC
Number of Zones:: -
Ventilation
Bathroom Fan:1
Exhaust Fanf—
Attic ExhaustF—
Residential Hood :F-
Commercial Hood:: -
Metal Fireplace:F—
Gas Line:: -
Fire Dampers::-
New Construct! Electrical
on Quantity Bathroom
1 & 2 Family S.F:r—
Multi Family S.F::
Receptacle, Switch Lighting Outlets
Total Outlets::
Lighting Fixtures
Total Fixturesr—
Total Low Voltage:r—
Separate Circuit:-
Motors/Transformers
0-1 HP or KVA:F-
1-10 HP or KVA:F-
10-50 HP or KVA::-
50-100 HP or KVA:-
Over 100 HP or KVA:r—
Signs
One branch circuit:r—
Add'I branch circuit _
Service
0-600V not over 200A::
0-600V & over 200A::
over 600V.-I
Temp PP/Piggy Back:: -
Sub Panel :r—
Other:r—
Plumbing
Quantity Quantity
Water closet (toilet):: -
Bidet:
Urinal :F-
Bath Tub ::-
ShowerstalhF-
Lavatory (basin)f -
Hydro -massage tub::
Kitchen
Kitchen sink:_
Garbage Disposal::-
Bar sink:
Vegetable sink:F—
Dishwasher:-
Laundry/washing trap:: -
Ice maker:
Floorsink:F-
Miscellaneous
Floor drain:: -
Water piping:F-
Watersoftenerf -
Water heater:
Lavatory (basin):r—
Gas sys up to 4 outlets:�-
Gas Sys n of outlets over 4::-
Backflow device up to 2":-
Backflow device over 2"f---
Regulators
Lawn Sprinkler System::
Roof drains
Hose bibb::-
Orin king fountain::
Grease trap ::-
Grease interceptor
P-trap::
Sewer
Newsewer:
Sewer alter/repair:F
Sewer abandonment::
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