HomeMy WebLinkAboutE2024-0006 - Permit ApplicationP. int Form Worksheet for Electrical/Mechanical/ Plumbing Application
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City of Newport Beach
Building Division
1. Project Address (Not mailing address)
Building Permit No. 10024 G_Zt�k - Gi0
c- i J e-0 Floor F—Suite �—
I— 2.Owner's Name Last ` LX First S e�
Owner's Street Address I cl �g �
o3 l�.11bAv v. City AlfwVA- l� I%.%0-
State Zip ot�CxT
Telephone 650-d65-%k87 Owner's E-mail Address 5JI-, Q Zov-ckK. VS¢.`
r 3.Appiicanfs Name Last S �,.4 First
A licant's5tL tAddress
16�5�G J i1bti ��Cc City v,.,,LQ StateFT Zip �d605
Telephone `19 7-5651 Applicant's E-mail Address JpIn1nGS'F2e�.�aa/grvwi�,Ww�
r 4. Contractor's Name Last S 1-ee N First �ats� State Lic 4 c, 8D 1
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Contractor's Street Address
City State F_ Zip ( —
Telephone Contractor's E-mail Address Business Lic a I —
Mechanical
Furnace Quantity
up to 100,000 btu::
over 100,000 btu::—
wall/floor 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 btuF—
Boilers/Compressors
up to 3 HP:r—
3HP-15 HPf
15 HP-30 HP:-
30 HP-50 HP::—
>50 HPF—
Air Handling Units
up to 10,000 CFMT—
> 10,000 CFM:—
VAV Box::—
Repair/Alter/Add HVAC
Number of Zonesr—
Ventilation
Bathroom Fan: —
Exhaust Fan: —
Attic Exhaust!
Residential Hood:_
Commercial Hoodr—
Metal Fireplace::
Gas Line: —
Fire Dampers: —
Electrical
New Construction Quantity Bathroom
1&2
itch Lighting Outlets
Total Outlets
Total Fixtures::
Total Low Voltage:
parate Circuit:
0-1 HP or KVA:
1-10 HP or KVA::
10-50 HP or KVA::-
50-100 HP or KVA::—
Over 100 HP or KVA:
Signs
One branch circuit::
Add] branch circuitF—
Service
O-600V not over 200A:-
0-600V & over 200A::
over 600V:
Temp PP/Piggy Back:
Sub Panel:
Otherr—
Plumbing
Quantity Quantity
Water closet (toilet):
Bidet:
Urinal:_
Bath Tub::
Shower stall:
Lavatory (basin):
Hydro -massage tub:[ --
Kitchen sink::
Garbage Disposal::
Bar sink:
Vegetable sink
Dishwasher
Laundry/washing trap:
Ice maker:
Floor sink
Miscellaneous
Floor
avatory (basinpF—
Gas sys to 4 outlets::
Gas Sys s of out s over 4::
Backflow device up to 2":r—
Backflow, device over 2"::
Regulators::
Lawn Sprinkler System:
Roof drains:
Hose bibb::
Drinking fountain::
Grease trap::
Grease interceptor:
P-trap::
Sewer
New sewer::
Sewer alter/repair::
Sewer abandonment
3,kv `�