HomeMy WebLinkAboutR2020-0513 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT ,,ecEiVED al,
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BUILDING DIVISION Co
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RBR*Tt ZOU t' �/ www.newportbeachca.gov 1 (949) 644-3200 JUN 2 5 2020
Application for Report of Residential Building
Please type or print and complete all information
# of Units: F Address: P City: Newport Beach State: CA Zip: d�
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Property
Zip Code: RW ?Z -
Owner Address:
State: CA
Owner's Authorized Agent: I Work Phone:
Agent Address: C/ 3
City: - e E`
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State:
F Z ---, Zip Code: Agent Email Address:
Escrow Company
Escrow Address ��% v Z City:
State. Zip Code:
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Email Report to:
For Inspection cal
Escrow #: I �ko — ( l5 �. Mv ,...
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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