HomeMy WebLinkAboutR2022-0053 - Permit ApplicationCity of Newport Beach
COMMONtTY DEVELOPMENT DEPARTMENT
Eit11LDIN(a DIVISION
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!' 100 Civic Center Drive l P.O. Box 1768 1 Newport Beach, CA 92658^8915
RBR#:V2427-oo�3 www.newport4eachca.eavl(949)644-3200
Application for Report of Residential Builtlinn';Records
COMMUNITY
DEVELOPMENT'
FEB 012022
CITY OF
Please type or print and complete all Information
# of Unita:
Property Owner.
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Owner Address
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Owners AuthorizedAyent, MelBsaEtarGie .. _...i _....:, .,�WarkPhone: . „,,.....,, ..,
Agent Address
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ZipCode. .:92860...... .._: mm.: Agent Email Address:
E§crow Company.
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Escrow Address
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Zip Code i 56t7 E ,.: ,.:.,.._ Escrow Phone: '= i 91 =t m0
Email Report to:brI
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For Inspection call
(Name)
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CONSENT TO INSPECT'WORM MUST SESIGNED AND DATED BELOW
Account # OiO50504-521040 ...........Make checks payable to CITY OF NEWPORTBEACH
Buldjng_omsronlFb=sSRBR 77-21