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City of Newport Beach COMMU11417 V
COMMUNITY DEVELOPMENT DEPARTMENT nE\/EI.Or'aa.:nr
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8945"R 2 i ?020
www new ortbeach v 1 (949) 644-3200
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Application for Report of Residential Building Record_
# of Units Address:
Property Owner:
Please type or print and complete all information
City :N Pctr#, each,; Sate m Zip 9 66b,
Owner Address :rpt)°?t.AlsoAenue hmml" ` <.m City:
State � Zip Code:
Home Phone:
Owner's Authorized Agent i B6I Colucclo' J Work Phone:
Zip Code: .92627
Agent Address 450nNp N oI# City. ;'Newpiirt Heaph,
State CR; _ Zip Code 192660,:0 ._ :.;_' Agent Email Address:
Escrow Company..��1ii(it'Esrt)17,Srs(ilettaelaf.ervlces3 ,' w1,;a:Escrow#:
Escrow Address 450`NR brt egier,.,Dry ,.Suite SOAeg
c ....,.c::i City:
State. CA ,. Zip Code: 2669F Escrow Phone: .(�R9)720 01 t0......_:..
Email Report to fgriffbti` 9 It ,imrdwzam ....; ...
For Inspection call (Name):
Direct Phone. r -I
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH
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April 23, 2020
City of Newport Beach
Attn: Building Division
P.O. Box 1768
Newport Beach, CA 92658-8915
ENCLOSED PLEASE FIND:
- Application for Report of Residential Building Records
- Credit Card Authorization Form
Let me know if you need anything else to complete our request.
Escrow Officer
450 Newport Center Drive, Suite 600
Newport Beach, CA 92660
Tel: (949) 720-0110
Fax: (949) 720-0145
Email: tgriffon@graniteescrow.com