HomeMy WebLinkAboutX2010-3071 - Permit ApplicationPrint Form Worksheet for Electrical/Mechanical/ Plumbing Application zEWPoq>
- City of Newport Beach
Building Division
1. Project Address �Z W`R r` e
(Not mailing address) Building
�t Building Permit No.
V , CA A" e Floor �— Suite �—
r 2. Owner's Name Last First
Owner's Street Address ��,, �.sIf1
LJ t'Z- W . �`�'�� Ave% City n(tts:�t"✓?1i1 h7�+a.w State Zip 92%lC��
Telephone FOG-'?�j�-'(xf(p� Owner's E-mail Address
F_ 3. Applicant's Name Last I rV First �TVIi�
Applicants Street Address `
731CO C,14 (JPr Pf7- Or IC)1 City LLS State XX Zip -1&9
Telephone QrtSi - J l J -100 Applicants E-mail Address _X;Outou V L6 Ip#uv's Om
F 4. Contractor's Name Last
Contractor's Street Address
Telephone
Mechanical
Furnace Quantity
up to 100,000 btu :7—
over 100,000 btu::
wall/floor heaters:
Heat Pumps/Package Units
up to 100,000 btu:F_
up to 1,000,000 btu:F-
up to 1, 750,000 btu:F—
> 1, 750,000 btu:f
Boilers/Compressors
up to 3 HP:F-
3 HP-15 HP::
15 HP-30 HP:
30 HP-50 HP::
>50 HP::
Air Handling Units
up to 10,000 CFM::
> 10,000 CFM::
VAV Box::
Repair/Alter/Add HVAC
Number of Zones::
Ventilation
Bathroom Fan::
Exhaust Fan:
Attic Exhaust:
Residential Hood
Commercial Hood
Metal Fireplace:
Gas Liner
Fire Dampersi
City
Contractors E-mail Address
First
Electrical
New Construction Quantity Bathroom
1 & 2 Family S.F::
Multi Family S.F.:
Receptacle, Switch Lighting Outlets
Total OutletsF —
Lighting Fixtures
Total Fixtures:
Total Low Voltage:r—
Separate Circuit::
Motors/Transformers
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'I branch circuit
Service
0-600V not over 200A:
0-600V & over 200A::
. over 600V:F
Temp PP/Piggy Back
Sub Panel::
Other:
State Lic #
State F_ Zip F_
Business Lic# F-
Plumbing
Quantity Quantity
Water closet (toilet)
Bidet::
Urinal ::-
Bath Tub::
Shower stall::
Lavatory (basin):
Hydro-massagetub:F—
Kitchen
Kitchen sink::
Garbage Disposal:_
Bar sink
Vegetable sink
Dishwasher:-
Laundry/washing trap::
Ice maker::
Floor sink
Miscellaneous
Floor drain:
Water piping:
Water softener:
Water heater:
Lavatory (basin):
Gas sys up to 4 outletsf —
Gas sys # of outlets over 4::—
Backflow device up to 2"::
Backflow device over 2":-
Regulators::
Lawn Sprinkler System
Roof drains::
Hose bibb:F_
Drinking fountain:
Grease trap:F_
Grease interceptorF
P-trap:
Sewer
New sewer:: —
Sewer alter/repair:
Sewer abandonment::