HomeMy WebLinkAboutR2020-0528 - Permit ApplicationC,EIVED E'Y
COMMUNITY
bEVELOPMENT
City of Newport Beach ,JON 3 0 2020
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 CITY OF
www.newportbeachca.gov 1 (949) 644-3200 4�nORT 5'�Po2`
Application for Report of Residential Building Records
Please type or print and complete all information
#of Units: M Address 28;abig_Sahs, .,.,,_r.:_� City .New ottt3each'; Sate _CA,, Zip.65Z..,. ...
Property Owner:
Owner Address:
State: � Zip Code:
Owner's Authorized Agent:
Home Phone:
Agent Address: 146001N2M--C. WOO
State: "C:A :=a Zip Code �I?&60 4 ;;;,. c Agent Email Address:
Escrow Company:
Zip Code:
City
Work Phone
City:
Escrow #:
Escrow Address
.
450 N' .
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City
New ,a Be `ch
State=;CA.....::
Zip Code:'9
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Escrow Phone.
9.Q9
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Email Report to:
For Inspection call (Name):
Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH