HomeMy WebLinkAboutR2021-0672 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
V101 I, � f 100 Civic Center Drive P.O. Box 1768 1 Newport Beach, CA 92658-8915
1113.(7 (�J(� www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Please type or print and complete all information
#of Units:1❑ Address: __ 313 Onyx Avenue city: New ort Beach State: CZip: 92662
Y P
Property owner: —71
Ingrid Bruder Zip Code:
Owner Address: City: '....
State: CA Zip Code: F-771Home Phone:
Owner's Authorized Agent: Work Phone
Agent Address: I City:I —
State: I Zip Code: F-7 Agent Email Address:
Escrow Company: Freedom Escrow Escrow #: 054933 -MM
Escrow Address: 1200 Newport Center Dr., Suite 180 city: LNew ort Beach
State: Cq Zip Code: 52660 Escrow Phone:(949) 644-3939
Email Report to: mm@freedOmeSCfOW.COm '',
For Inspection call (Name): N/A Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Bmming Dmision\Form:\RBR 7i -u