HomeMy WebLinkAboutH2023-0601 - Permit ApplicationWorksheet for Electrical/Mechanical/ Plumbing Application
City of Newport Beach
Building Division
1. Project Address (Not mailing address) Building Permit No.
F_ 2.Owner's Name Last First
Owner's Street Address
City
Telephone 1 Owner's E-mail Address
i— 3. Applicant's Name Last
Telephone
r 4. Contractor's Name Last
Contractor's Street Address
I ex61::, L-iAc014%
Telephone //l(_ 6� 37 -/
Mechanical
up to 100,000 btu
over 100,000 btu., F_
heaters:r—
Heat Pumps/Package Units
up to 100,000 btu:F--
upto 1,000,000 btu-F`_
up to it 750,000 btu:r—
> 1, 750,000 btu:r—
Boilers/Compressors '
up to 3 HP:_
3 HP-15 HP:I11 I
15 HP-30 HPr-
30 HP-50 HP:r—
>50 HRIF
Air Handling Units
up to 10,000 CFM:I
> 10,VA 0
V Bo
Repair/Alter/Add HVAC
Number of Zones:F---
Ventilation
Bathroom Fan i—
Exhaust Fan.F—
Attic Exhausts --
Residential Hood'
Commercial Hood:r—
Metal Fireplace:)
Gas Line:'
Fire Dampers;
1pNicant's E-mail Address
!e^ �..f Pl.`I � n `
Ky ;
:ontractor's E\maillress
Elect al
New Construction
1 & 2 Family S.F:
Multi Family S.F1
Receptacle, Switch Lighting
Total Outlets:l
Lighting Fixtures
Total Fixt1rt?s:1
Signs
Service
First
city �—
LFir�st'�F�'
city l �
I n70 (P-C G C
Quantity
Circuit)
l--
0-1 HP or KVA:r'
1-10 HP or KVA:I_-
10-50 HPorKVA:r-
50-100 HP or KVA��—
Over 100 HP or KVA:r—
One branch circuitre
Add'I branch circuitr�
0-600V not over 200A.:r—
0-600V& over 200A:I
s"
over 600V:i
Temp PP/Piggy Back:
Sub Panel:r—
Other!
IGal
Floor I Suite
State F Ap :—..--
Zip I
State Lic #
State I Cft Zip S7
m Quantity
Water closet (toilet):r—
Bidet:r—
Urinal
Bath Tub:r`
Shower stalkr—
Lavatory (basiN:r—
Hydro-massagetub:r—
Kitchen sink:1
age Disposal :r—
Barsink:r—
age blesink:r__
Ice maker:
Floor sink,
Miscellaneous N
Floor drairer—
Water piping:
Water softened
Water heater:I
Lavatory(basin)i
Gas sys up to 4 outlets
Gas sys # of outlets over 4:r_
Business Lic# F_
Plumbing
Quantity
Backflow device up to 2":r-
Backflow device over Z'
Regulatorsr�
Lawn Sprinkler System:r—
Roof drains
:r—
Hose bibb::
Drinking fountain::
Grease trap:r—
Grease interceptor:r—
P-trap:F
Sewer
New sewer
Sewer alter/repair:r—
Sewer abandonment:r�