HomeMy WebLinkAboutR2022-0067 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
Wqj40 ^ 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# U �" 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: 1855 Port Manleigh Place City: Newport Beach State: CA Zip: 92660
Property Owner: Robert & Kelly Berkus 7 Zip Code:
Owner Address: City:
State: CA Zip Code: C� Home Phone:
Owner's Authorized Agent: �— Work Phone: �—
Agent Address: City:
II-- i
State: Zip Code: Agent Email Address:
Escrow Company: Freedom Escrow Escrow#: 055168 -MM
Escrow Address: 1200 Newport Center Dr., Suite 180 City:New ort Beach
State:
Cq zip code: 92660 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
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