HomeMy WebLinkAboutR2021-0433 - Permit ApplicationCity of Newport Beach
pi MUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION If Al��\
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA '58-8010 10
RBR# www.n(-wportbeachea.gov 1 (949) 644-3200
7
3, 7
Zip Code:
Pro pertyOwnd.,
Owner AddreAl /w City:
_J
State: FA Zip Code � F Home Phone: F
---------------------------
Owner's Authorized AAgent: Work Phone: Wr
Agent Address: City:
---------- --------- —
State: Zip Code:
F (W CZ4
4( 0 Agent Ernaii Address!
Q
Escrow Company: Escrow #: L,, 2 `7 A
7 -777T -4–t-11
tscrow Ado. resE: icy:II
61
State:
Ernail Report to:
For hispecLion call (Nzlrne): Direct phone: F77777-7
CONSENT TO INSPECT
-JF [�M-MUST BE SIGNED& DATED BELOW).
Agent's,signatLfr(`, todecline insPectibrr Date:
106/11/2021
----- ------------------- --------------------- — ------
Account # 01050504 521040 ....... -Make checks payable to: CITY OF NEWPORT PEACH
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Please tvpFL!2rprint d_co pfete all information
11 of Units:
F
Address � - ity: Newport Beach State:
7-3 ""1 1 1
F(A Zip:
7
3, 7
Zip Code:
Pro pertyOwnd.,
Owner AddreAl /w City:
_J
State: FA Zip Code � F Home Phone: F
---------------------------
Owner's Authorized AAgent: Work Phone: Wr
Agent Address: City:
---------- --------- —
State: Zip Code:
F (W CZ4
4( 0 Agent Ernaii Address!
Q
Escrow Company: Escrow #: L,, 2 `7 A
7 -777T -4–t-11
tscrow Ado. resE: icy:II
61
State:
Ernail Report to:
For hispecLion call (Nzlrne): Direct phone: F77777-7
CONSENT TO INSPECT
-JF [�M-MUST BE SIGNED& DATED BELOW).
Agent's,signatLfr(`, todecline insPectibrr Date:
106/11/2021
----- ------------------- --------------------- — ------
Account # 01050504 521040 ....... -Make checks payable to: CITY OF NEWPORT PEACH
D