HomeMy WebLinkAboutR2020-0808 - Permit ApplicationOocuSign Envelope ID: E78CBBD0-87AE-43CF-9849-C27544703F64
City of Newport Beach
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
IGO, Civic Center Drive I P.O. Box 1768 Newport Beach, CA 926J X�-8w
,R# www.newportbeachmgov (949) 644.3200
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Application for Report of Residential Building Records
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RiainspertIon F ee $129 00 or incomplete will bpi r
Please type or Print and complete all information, F,-pC1.A
of Units: El Address: ity:Newport BeachState: ZI;x F1
IropertyOwner; tri0(%gV ZqCode:
)wner Address, 1 -�7 i! aw p;
;tate- J Zip (:ode; Horne Phone:
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city:
,ess:
Emell, Report to: I :S (a4tin2e1e- R rl CKAYd Cc COW - C~
For Inspection call (Name)t Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOWI
a 0rty (tsted above l �inderstancl that YF Betiding ar Zoning
violations are d1:jcovered t wilillerespo nsibie't'oeksaidvia(attan5 `,
Owner/Agent's signature to autl4brize inspection: Date.'
OR.
Docusloned by'
Owner/Agent'ssigna'tutetadeiclineinspec�ion:, 4U7 ft PdA 9/21/2020'
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Zip Code;
city:
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Escrow #1
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Escrow Phone:
Emell, Report to: I :S (a4tin2e1e- R rl CKAYd Cc COW - C~
For Inspection call (Name)t Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOWI
a 0rty (tsted above l �inderstancl that YF Betiding ar Zoning
violations are d1:jcovered t wilillerespo nsibie't'oeksaidvia(attan5 `,
Owner/Agent's signature to autl4brize inspection: Date.'
OR.
Docusloned by'
Owner/Agent'ssigna'tutetadeiclineinspec�ion:, 4U7 ft PdA 9/21/2020'
VVV �ESE07E3FC977408