HomeMy WebLinkAboutR2020-0891 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR# www.newportbeachca.go 1 (949) 644-3200
Application for Report of Residential Building Records
Please type or print and complete all information
#of Units: = Address:".V
I Alta . iiiaLbijv1 City: Sate: M zip: 92660
Property Owner.
Zip Code:
Owner Address: 12$2.1 tjj�V al,o.f�hl
At . r
City: ;NrevSpM,9��",W,.'�,,::7."-.
State: = Zip Code:
Home
Owner's Authorized Agent:
Work Phone:
Agent Address: `!
. City: Ffbntlilo dach.
State: CA Zip Code: Agent Email Address:
Escrow Company: Escrow #: 1.$.0700.140 -CK
Escrow Address: 425 30th ;,95�dtSuite`2 = city: , .J
., � 7i � !
State: = Zip Code:
i,
Escrow Phone:
Email Report to:
�!2
For Inspection call (Name):0AA;::- " =`f: Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH