HomeMy WebLinkAboutR2022-0190 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Bax 1768 1 Newport Beach, CA 92658-8915
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Application for Report of Residential Building Records
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COMMUNITY
DEVELOPMENT
APR D 7 2022
CITY OF
ORT B@PGS
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Owner Address
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City
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Zip Code: E50 ,y,;,m®'
Home Phone:
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Owner's Authorized Agent CLtstc Tv)cE�itsperr ''`, , r.... ? ,j Work Phone:
Agent Address
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Zip Code a260, _,..... .:
Agent Email Address:
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Escrow Company {3,r,ixi e! "s"crow $1)fement:aervtceS..._ ; . _ ..m.._ Escrow # p436i65 LG, 3.....
Escrow Address11uDNew,trr(Ce7t.(eYi3:[e,,,Suit_SOp .__._µrd: _::::: ;... _:€ City flew art€t3each_.....:.
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State: =C,A,,,,„ Zip Cade s', ; 560 ,_.mG: ...:_:.: Escrow Phone
Email Report to 1 riffon ° randescrauv aan4 ;;;r2„g, ....: '............n..:,
For Inspection call (Name) _... n : r.' T: Direct Phone.
CONSENTTO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH
Building_DMsion%Foms\RBR 7-1-21