HomeMy WebLinkAboutXR2022-2199 - Permit Application (3)Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division "
G4pPPP
1. Project Address (Not mailing address) Building Permit No.
-�04--i'__.� -.. .--.. .... _.-___..-----...-__..--�-�---Floor �-� Suite
�l 7r�
2.Owner's Name Last First rnc,
Owner's Street Address Lr^
city
tiles`} )ei�State Zip
�_� __. �_ mac.' - ��'
Telephone it7^I)- ��1'�wners E-mail Address
3. Applicant's Name Last �{; tvnV,f _I Firste--
__ - - City \/`�.- _I- _.._
Applicant's Street Address �-t /
i't-C-.� __ _ . I � "� State � zip
Telephone ��.- ' \'�_TApplicant's E-mail Address
4. Contractor's Name Last YGta^d� First �t_.Cr ,'C- State Lic# _. _ 1. _.. -
Contractor's Street Address
Telephone a," I `L -„ Contractor's E-mail Address
Mechanical
Furnace Quantity
up to 100,000 btu:
over 100,000 btu:r—�'i
wall/floor heaters:
Heat Pumps/Package Units
up to 100,000 btu:F—I,
up to 1,000,000 btu:F—
up to 1, 750,000 btu::.
> 1, 750,000 btu:
Boilers/Compressors
up to 3 HP:7—'
3 HP-15 HP:F.
15 HP-30 HPF-
30 HP-50 HP-.F_
>50 HP:�—'
Air Handling Units
up to 10,000 CFM:r—'i
> 10,000 CFMF777
VAV Box:r
Repair/Alter/Add HVAC
Number of Zones:F —i.
Ventilation
Bathroom FanF —
Exhaust Fan:—,
Attic Exhaust:_
Residential Hood:
Commercial HoodF—
Metal Fireplace:.-.
Gas Line :F—
Fire Dampers:..
I city State �-/' Zip
Ga,Cc
Electrical Plumbing
New Construction Quantity Bathroom Quantity Quantity
1 & 2 Family S.F7�
Multi Family S.F:77
Receptacle, Switch Lighting Outlets
Total Outlets:
Lighting Fixtures
Total Fixtures:�i
Total Low Voltage: —I
Separate Circuit. —I
Motors/Transformers
0-1 HP or KVA:F77
1-10HPor KVA 7
10-50 HP or KVA:�_'i
50-100 HP or KVA:7-11
Over 100 HP or KVA:I—_ __
Signs
One branch circuit: —I
Add'I branch circuit:,
Service
0-600V not over 200AT._Ii
0-600V & over 2004-7
111
over 600V:���---r__ _iy--
Temp PP/Piggy Back:l �--/ ,
Sub Panel:
Otherr—
Water closet (toilet):
Bidet:
Urinal
Bath Tub:F—
Shower stall:_
Lavatory (basin)::
Hydro -massage tub:.,
Kitchen
Kitchen sink:'
Garbage Disposal F-7
Bar sink-F
Vegetable slnk:r—
DishwasherE,
Laundry/washing trap:[_�
Ice maker.',
Floor slnkF
Miscellaneous
floor drain:
Water piping:,
Water softener.?
Water heater..
Lavatory (basin):!
Gas Sys up to 4 outlets
Gas Sys # of outlets over 4:F
Backflow device up to 2':i1
Backflow device over 2"177
Regulators:r
Lawn Sprinkler5y5tem:177,
Roof drains.
Hose bibb:�
Drinking fountain:
Grease trap:
Grease interceptor:F____i
P-trap::
Sewer
New sewer
Sewer alter/repair.
Sewer abandonment::