HomeMy WebLinkAboutR2021-0572 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
gJ02j_ op)j 7 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Please type or print and complete all information
# of Units: 17 Address:Ll 16 29th StreetCity: Newport Beach I State: [CAZiP[T26(3L3_
Property Owner: 105-ou Zip Code: F777
Owner Address: 1 -1 City: F
State: rCT7771 Zip Code: F--] Home Phone:
Owner's Authorized Agent: Work Phone;
Agent Address: [ City:
State: 7----� Zip Code: F-7- Agent Email Address;
Escrow Company: Freedom Escrow Escrow #:[0754k574-WM-777--7]
Escrow Address: 1200 Newport Center Dr., Suite 18 —7 City: F�7ewp—ort--
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State: Cq Zip Code: F 92660 Escrow Phone: [(949) 644-3939__
Email Report to: F@freed.ornescrow...conn
For Inspection call (Name): N/A Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: UTY OF NEWPORTBEACH
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