HomeMy WebLinkAbout22-7-20 Signed appr:i➢ . ,
0'
CiVic Center Drive
Newport h, . CA 91660
'n* eW04
"Date of Application: 4,
'Property
" Buyer's Names:
A"A/iS Sir^ +,....,..
R M'
Telephone Nu:: _Es �ES'ati
Joint Owner
"Escrow Company:
'EscrowUmber: 05!
*'"Closing Date (Estimate): all
*STARRED ITEMS MUST BE
y;
ED
Inspection Date. Reinspectioti Efate.
Fee Paid`. <� Check Nos,'��
Application Complete.
Public Works SigthaturelDate,
Special Conditions: This permit is revocable by the City Council
In accordance with Trtfe 17 of the Newport Boach Municipal Code.
Date:
Inspection Requested By:
Inspector:
Pier Address:
INSPECTION FORM
Public Works
3g/v a2tie V—
Pier Transfer
Reinspection
GFI Present ff Yes —Neeedd None Needed Yes Need
Anti -Siphon / Backflow Present W
Other Comments
Comments / Observations
Other Request