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HomeMy WebLinkAboutR2021-0184 - Permit Applicationrrt;;~lVi::IJ 1;^y coikii14l1PI1lY DEVELOPM t'_ N7 City of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT MAR 0 J 2021 BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 zJiTY Oi= www.newportbeachca.gov 1 (949) 644-3200 "J�r C\I. RBR# Application for Report of Residential Building Records # of Units: L:._] Address: Please type or print and complete all information City ,New brt;Beach z Sate CP Zip: `92fi63 Property Owner: 1 tin:Cook h 411ee;pf t)te"Kp"sten CopkUMust, J a', `Tvlarch.23; i999 "' Zip Code: Owner Address: State. s-_. ?.. Zip Code:3j City: Home Phone: =`a a ,,,s,U.,, .._n .'OR ... ..._.. ...v.sh .. '..un Owner's Authorized Agent12K.-flAb nk,. 3, s etw ..,.",' Work Phone Agent Address: 450ANev lith, etlter:Ar100 , .,.,,. _: City: State: � Zip Code Agent Email Address: '=92fi60 m....." z= kp Escrow Company.# ramie' § rnw_&,, a (i"001$60le r ,;; a ......'; Escrow #: Escrow Address 45©.(fey✓ fii,Le ter.DtijSr51(efi00 H City Mew o08aeh, State: � Zip Code: Escrow Phone: Email Report to: 14,011,01 ran n ltees�rointppm.',.. _ � : _.__..�...... F^r ..... ,. _.... ._... __.... st,.-..: For Inspection call (Name) ....., t r _.... ;. `r ...._,..' ` ,....__. ?: _s.... ! .: Direct Phone CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH