HomeMy WebLinkAboutXR2024-6136 - Permit ApplicationPrint Form Worksheet for Combo Building & Solar Permit Application
F Comm'I 19-Residential City of Newport Beach - Building Division
NOTE: PLAN CHFCK FFF.c ni iF AT Tmnc no CI ionelr ..,
---'-----��-..� ri uIVIIIIHL V
uilding r Grading j—Drainage r Elec r Mech r Plum cuYdCut Cu Yd Fill
Project (Not mailing address) i— Flood r Fire j_ Liq r Landslide FN/A Floor Suite No
/Address
i 'l7 V eH
F_ F—
Description of Work
Use )z3U ConstType
# Stories # Units (if Res)i
Valuation $ l 0�
Material/Labor � y
!V`n.0 ��y1,f r Sitiv-car'
`l'• �pl TuY✓/ /Vfw ��ryplaur
New/Add SF�— Remodel
SF (
�� Garage/New/Add I
OWNER'S NAME Last
n^ —� --
/„'th0, First 7
Owner's Address
Owner's E-mail Address
3"1 AV V� f,,, .
L vh�vrir
City M(„/p -1 State[t
7G /4 Zip
? ZI G S'? Telephone gyq_G�3_q y� 2
APPLICANT'S NAME Last
V )1,y� pyy� First I --T;—� /N S
Applicant's Address
Applicant's E-mail Address
67 ' (d
City ( y �� State
Zip GZlsUI Telephone qq?-. 5-0 _4-7
(( lS
ARCHITECT/DESIGNER'S NAME
Last c
/Jd,n.. 0 .cPy/ % /,� .3 First 7— Lic. No.
Arch itect/Designer's itect/Designer's Address
// Arch itect/Designer's E-mail Address
City
State �— Zip �— TelephoneF�
ENGINEER'S NAME Last
First Lic No.F!
Engineer's Address
Engineer's E-mail Address
City
State F— Zip F_ Telephoned--
CONTRACTOR'S NAME/COMPANY
LicNo. F ClassF
Contractor's Address
Contractor's E-mail Address
IL1 }}L,5Ar,5 SfiL
$20y yr.'kcIk60 &' lvft, ✓1dfr5,cl.cry.
City F� N/ / /' A
State 6 — Zip 4(2(/ 1 Q" Telephone
SETBACKS REAR
SETBACKS FRONT PERMIT NO.�OZy.�'
SETBACKS LEFT
SETBACKS RIGHT PLAN CHECK NO.
USE ZONE
DEVELOPMENT NO PLAN CHECK FEES $
Pint Form Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division 5 r
1. Project Address (Not mailing address) +<,.oan�•
Building Permit No.
----------------------- ------ Floor
Suite
2.Owner's Name ---- ---- -- ----
Last - �Irl�r„ _,_-,_ A First
s+..o-r r�,� r _ Owner's Street Address "-��'�r--L ������—p�-�`-�
V -__-_--- City �-'-�r-� ,&4 State C Zip I%
Telephone _ Owner's E-mail Address
[, 3.ApplicanVs Name Last ----- First - -- ------
.-_ M -_ First _,--�
A licant's street �A,,ddress -------- -r �o� S-�____ CrtY -A;* %to ivq� j State Zip
Telephone T •1-3CH.74 Applicant's E-mail Address 171
Co r Contractor's Name Last -
____� i First State Lic# Contractor's Street Address -------------- - --
Telephone I
._ city F77— State Zip I
Contractor's E-mail Address
_� Business Lic#
Mechanical
Electrical
Furnace Quantity
New Construction Quantity
up to 100,000 btu—,
1 & 2 Family S.FT—
over 100,000 btuF--
Multi Family S.FF -.
wall/floor heaters-,
Receptacle, Switch Lighting outlets
Heat Pumps/Package Units
up to 100,000 btu:-
Total Outlets.r I l
up to 1,000,000 btu--,,
Lighting Fixtures
UP to 1, 750,000 btuF--
Total Fixtures I s
> 1, 750,000 btur-
Total Low Voltager-
Boilers/Compressors
up to 3 HPF—,
Separate Circuit-,
- 3 HP-15 HPF
Motors/Transformers
15 HP-30 HPr-
0-1 HP or KVAC
30 HP-50 HPC-
1-10 HP or KVA177
>50 HPC-
10-50 HP or KVAri
Air Handling Units
50-100 HP or KVAC_
up to 10,000 CFMF--
Over 100 HP or KVAF-
> 10,000 CFMF -:
Signs
VAV Boxt-
One branch circuit
Repair/Alter/Add HVAC
Number of Zones-
Add'I branch circuitq(--,
Service `'---
Ventilation
Bathroom Fan )-
0-600V not over 200AI7'
Exhaust FanE—
0fi00V&over 200A1
Attic Exhaust — '
over 600VF—
--
Residential Hood--
Temp PP/Piggy Back
—
Commercial Hood -
t
Sub Panel
Metal FireplaceF--
Other
--
Gas Line
Fire Damperst-
Plumbing
Bathroom Quantity Quantity
Water closet (toilet)_
Bidet i
Urinal --
Bath Tubt
Shower stall!'
Lavatory (basin)
Hydro -massage tub)!
Kitchen
Kitchen sink Fl
Garbage Disposal
Bar sink
Vegetable sink
Dishwasher
Laundry/washing trap
Ice maker --
Floor sink
Miscellaneous
Floordrain[7-.
Water piping:
Water
Gas Sys up to 4
Gas Sys # of outlets
Backflow device up to 2-F
Backflow device over 2"t-
Regulatorsf-
Lawn Sprinkler Systemt-
Roof drains_
Hose bibbF
Drinking fountaik—
Greasetrap�-
Grease interceptor
P-trapF-
Sewer
New sewer
Sewer after/repair—
Sewer abandonment