HomeMy WebLinkAboutR2021-0304 - Permit Application�FCEiVED 8i
City of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION APR 2 0 RECD
V100 Civic Center Drive P.O. Box 1768 1 Newport Beach, CA 92658-8915
���/�/;0 "� www.newportbeachca.gov (949) 644-3200 c,, DEVELOPMENT
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Application for Report of Residential Building Records pPMl�wPoP!
# of Units Address:
Property Owner:
Owner Address:
State = Zip Code:
Please type or print and complete all information
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Zip Code:
City:
Home Phone: F
Owner's Authorized A ent
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Agent Address:
State ,C;?k Zip Code:
Escrow Company:
Escrow Address:
City:
Agent Email Address: fieattatSarto@aol,ara
Escrow #:
City % ewpdrtt3eacttt -01 'm 111— 1W
State CS.
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Escrow Phone:
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Email Report to
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For Inspection call (Name):
Direct Phone ,In
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account#
CITY OF NEWPORT BEACH