HomeMy WebLinkAboutR2022-0055 - Permit Application,or'SVEO ai,,
COMMUNITY
City of Newport Beach DEVELOPMENT
COMMUNITY DEVELOPMENT DEPARTMENT FEB 0 3 2022
BUILDING DIVISION
�2d�Z'�OCi✓ 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92699W
1113111t www.newportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Records
Please type or print and complete all information
# of Units: Address: I L r� ��_� 10 City: Newport Beach State: CA Zip:
PropertyOwner: — ..--�___ZipCode:F
Owner Address: Q_.. ''; City: ._.N _ch �
State: CA-.. ...............i Zip Code: G..2...... Home Phone: I v ! .....
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Owner's Authorized Agent: I Work Phone:
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Agent Address: I i r) nn Yui -7-1N n (7(--F- city
State: ,i Zip Code: Q 0
Escrow Company: . _. Escrow #:ro r) + 1. _ (o
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Escrow Address: Cit
State:FCO Zip Code: r,' "�� Escrow Phone: C, a
_. (0 (0 0 of G B 241,
Email Report to:
For Inspection call (Name):
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Bu11d1ng_DIv1slon\FO,TS\RBR 9-18-19