HomeMy WebLinkAboutXR2024-6550 - Permit Application (2)_ P rint Form Worksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
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Floor
I 2.Owner's Name Last p-(l�ru First
Owner's Street _Address - � " ���
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Telephone
Owner's E-mail Address
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State (,v{- Zip a S-?r
r 3. Applicant's Name Last Ul I ✓n`u1 First j y
APplicant's Street Address - - --
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City iir i.n. State I "VT Zip 32n1.
Telephone JL4J,W.-(;7 5Y Applicant's E-mail Address hyr(J/(/✓YInYI c%g'Uh Gti ��`u�
r 4. Contractor's Name Last First State Lic# �-
Contractors Street Address _
Telephone
Mechanical
Furnace Quantity
up to 100,000 btu
over 100,000 btuf—
walUfloor heatersr—
Heat Pumps/Package Units
up to 100,000 btu_
up to 1,000,000 btur-
up to 1, 750,000 btuf--
> 1, 750,000 btuf—
Boilers/Compressors
up to HP
3 HP-15 HPI
15 HP-30 HPr-
30 HP-50 HPI
>50 HPF--
Air Handling Units
up to 10,000 CFMF-7-
> 10,000 CPMr-
VAV Box
Repair/Alter/Add HVAC
Number of Zones
Ventilation
Bathroom Fanr-
Exhaust Fan F-
Attic ExhaustF--
Residential Hoodr-
Commercial Hoodr-
Metal Fireplace!
Gas Line
Fire Dampersf-
Contractor's E-mail Address
Electrical
New Construction Quantity
1 & 2 Family S.FF_
Multi Family S.Fr
Receptacle, Switch Lighting Outlets
Total Outletst-�rC
Lighting Fixtures V
Total Fixturesr—
Total Low Voltage
Separate Circuit_
0-1 HP or KVAf-
1-10 HP or KVAf-
10-50 HP or KVAf-
50-100 HP or KVAr-
Over 100 HP or KVAF_-
Signs
One branch circuit[--
Add'I branch circuitF-
Service
G-600V not over 200Ar-
0-600V & over 2004 -
over 600Vf_-
Temp PP/Piggy Back_
Sub Panel!
Otherr-
City State F_ Zip F—
Business Lich F --
Plumbing
Bathroom Quantity Quantity
Kitchen
Water closet (toilet)FT-
Bidet
Urinal
Bath Tub
Shower stall
Lavatory (basin)FT—
Hydro-massage tubF—
Kitchen sink `�
Bar sink
Vegetable sink
Dishwasher
Laundry/washing trap_
Ice makerr
Floorsinkr--
Miscellaneous
Floor drainr-
Water pipingr-
Water softenerr-
Water heaterf—
Lavatory (basin)r-
Gas sys up to 4 outlets�-
Gas sys it of outlets over 4r-
Backflow device up to 2"F-
Backflow device over 2 J_
Regulators
Lawn Sprinkler Systemr-
Roof drainsf-
Hose bibbF
Drinking fountainF—
Greasetrapr-
P-trap�-
Sewer
New sewer
Sewer alter/repairF-
Sewer abandonment