HomeMy WebLinkAboutR2022-0715 - PermitsCity of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT'
BUILDING DIVISION n�1 99nngg
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CAJ.W89Y52
RBR# gzv2 2 www.newportbeachca.gov 1 (949) 644-3200
W-1 1 G CITY OF
Application for Report of Residential Building
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City: NewportBeach State:
CA Zip:
Property Owner:
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Owner Address: City:
State: CA Zip Code: 0�' Home Phone:
Owner's Authorized Agent: work Phone:
Agent Address: City:
State: Zip Code: 17771 Agent Email Address:
Escrow Company: J Escrow #
Escrow Address Z�� �.�(,U(j'�' , ,�y' �'C �;7).� City:
Stater Zip Code: tL1XCQ (] Escrow Phone: ---
Email Report to: I trnPC03 - e�aoyt� NyJ. C01/(� C tv vxuoVv(.fi r t,ur /--
For Inspection call (Name): �— —7 Direct Phone
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITY OF Nt WYUK1 BLAcn
Building Division\Forms\RBR_ -15-22