HomeMy WebLinkAboutR2021-0260 - Permit ApplicationRRR# VIW-6LU�
City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
1()0 t;.ivic CenterDrivt ( P.O::Bax 1768 I Newport: Beath, CA 92658-8915
www.neWoort6eachca.eoy ( (949) 644-3200
Application for Report of Residential Building Records
Please"type or print and complete all informailom
#'of Units:
Prgperty owner
Dean L:Jv#ilEer and.Moha Mr14er....: ...
_ . _....:. ,. Zip Code-
State. CA.......,
Zip Code.
Owner Address
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Escrow Address
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Owner's Authorized Agent. GtdhaDS a '' Work Phone. 1049:64 2 .f. .......
Agent Address:
City: :i9ew
State. CA.......,
Zip Code.
€ 9660 w AgentEmail_Address: =dicr fidrteil.catn.: ..
Escrow Comparry Escrow ,:I_„ .
Escrow Address
C Dt? e,'.vG te`. 't1 r city: :N peach i r:
450 N"tiitsi3eht
State
A ..a,u
Zip Code
Escrow Phone: -10 T4......._ .':.i.R`.. rs .
Email P.eport to
;'mcrii(lati%b raratteesCfoi com_ ..: a
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Por Inspection, call (Name)a.....:.a .... _... ._= Direct Phone, a, €;
CONSENT TO"INSPECT (FORM MUST 6E SIGNED AND DATED:FiELOW