HomeMy WebLinkAboutR2021-0769 - PermitsCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
IIn �t�00 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
V www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Please type or print and complete all information
#of Units: E Address: L,9SummerwalkCourt #42 City: Newport Beach State: CA'.Zip: g2661
Property owner: Tammy Bliss Zip Code: 1771
Owner Address: City:
State: CA Zip Code: LHome Phone:
II
Owner's Authorized Agent: F— Work Phone:
Agent Address: City:
State: ��� Zip Code: 1771 Agent Email Address:
Escrow Company: Freedom Escrow _ Escrow#: 055029-MM
Escrow Address: 1200 Newport Center Dr., Suite 180 City: [Newport Beach
State: CA J Zip Code: __ 92 Escrow Phone: (949) 644-3939
Email Report to: mm@freedomescrow.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 NEWPOFT BEACH
Buildin�Division\Forms\RBR 1-1-21