HomeMy WebLinkAboutR2022-0060 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
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: IT Address: 1337 E. baA Ft-ont City: Newport Beach State: ECA Zip:9 �,
Property Owner. �grre"Z.�2eY- Zip Code:
Owner Address: j?j� �, �p ��or,.{- City: \VC'SN o�Y se"cm
State: I- Zip Code: Q a/p Eia Home Phone:
Owner's Authorized Agent: Work Phone:
Agent Address: City:
State: Zip Code: Agent Email Address:
Escrow Company: YpR�pyr, C�.rOccl Escrow #: 055i(a3--DW
Escrow Address: I'J,pp New pIk City:
State: F� Zip Code: FZ(flp Escrow Phone:
Email Report to:
For Inspection call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORT BEACH