HomeMy WebLinkAboutR2022-0350 - Permits�CEIV�O gY
COMMUNITY
City of Newport Beach DEVELOPMENT
COMMUNITY DEVELDPMENT DEPAPTMEKT JUL 06 2022
BUILDING DrVISION
1DD Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
www.newpcirtbesachca.gov 1 (949) U4-32DD CITY OF
Application for Report of Residential Building'Records y�IPoaT
%ivoiicati�ea Fee::-$7 �q� •Notice:; .
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tY: Newport Beach State.
CA Zip:
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State; L� 23p Code:
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state: ,{I,s I Zip Cn e; Agent Email Address;
Email Report to:
For inspection call (Name): Direct Phone:
CDNSENT To INSPECT (FDRM MUST BE SIGNED & DATED BELOW)
1autFnrze fnspectrons.andre=iiaspection'safthe property fisted above. I understaridthaLrf RuOdingorzoning.
vialatinrasare discovered'I Wrill�liemspnresibl'eto correctsaid vinlatinns.
Owner/Agentssignature'to authorRze•inspeciam: INSPECTICN14
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Dwner/AgenC`ssigrcaturetn deciineirtspectinc:, �, Qate:.`-71 T
Account # 01050504-521D40 .................Make checks payable ta: CRY OF NEWPORT BEACH
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