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HomeMy WebLinkAboutR2021-0200 - Permit ApplicationCity of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 RBR# 1-� ` W D www.newportbeachca.gov 1 (949) 644-3200 Application for Report of Residential Building Records Please type or print and complete all information # of Units: Address 7� '�-7 I Cit Newport Beach State: CA v L xt �_ �I�i^' y' P i �_— —_-_ PropertyOwner: Owner Address: _ City: State: CA Zip Code: Owner's Authorized Agent: Agent Address: State: j Zip Code: Zip Code: F Home Phone: Work Phone: City: i Agent Email Address: r. Escrow Company: �lv��LYYI L�L,Yc'.i.� Escrow #: Escrow Address: City: N��Lj i�CiC State: ��'� -.,'. ( Zip Code: 94i( (' Escrow Phone: Email Report to: �OC��CVCS2G�U(11�r Ve:crY\ _i �)n� CYt Y�CM� (6L-0' C For Inspection call (Name): Direct Phone: h; q CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW) Account # 010SOSO4-S 21040 .................Make checks payable to: CITY OF NEWPORT BEACH Bu1lding_Divis1on\Farms\RBR_7d020