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HomeMy WebLinkAboutR2022-0078 - 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 U d l vU www.newoortbeachca.eov 1 (949) 644-3200 RBR# Application for Report of Residential Building Records Please type or Print and complete all information # of Units Address: €;80 Be" .,IidYe, R° t i.? -.,Ea, City: a1rSfidh :; Sete i$AE-` ZI 28 0 p Property Owner: Owner Address: State: = Zip Code: Zip Code: City: Home Phone:EE _w s k E2 els s a .121'm I Owners Authorized Agent �.afaTl lll7ithl€ !?' _-n-:`Fa ¢,e Work Phone: Agent Address:1. "r�,` �?aziSditem.. = city: ?:t?t"vu` State: � Zip Code: Agent Email Address: 1,,T4r . Escrow Company: ra ifetE }ta ... '" eme€1t; isfvl . r nl: ru..>. i Escrow #: 4# 9 5 7F E ,H errs _4 Escrow Address: ='4 w .r.._ -.4 iit ;�1'..r Ye`" plte �f) tdo- ,,. t'! �ev¢i� ''' i' �Pa,. Vin, City: State: CSA ... Zip Code. `„BQ� ,. ° ' ,;; Escrow Phone: ” 9?f ,7Z(L� f `4 ; SN", 3, Email Report to: atfr t '` CaTti.B@8C3i1N Ili , p_ ... - ?..4x, :. Imo.. _`. ,_,` e, s For Inspection call (Name) _..; _ r_..• . , e. „ ; ; Direct Phone: CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH Bu11d1ng_DNlelon%fo=skRBR_7-1-21