HomeMy WebLinkAboutR2020-0525 - Permit ApplicationCity of Newport Beach rO MPfiUNIT1 �
COMMUNITY DEVELOPMENT DEPARTMENT �)rz"VrI,0PM VN1
BUILDING DIVISION JUN 2 9 2020
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# '�:Z� Z — C7sZS www.newportbeachca.gov 1 (949) 644-3200 0TY0 r
Application for Report of Residential Building
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# of Units: C Address: j j ; `l ( City: Newport Beach State: aZip:
Property Owner: Zip Code:
Owner Address: ` `"���� City:
State: �� Zip Code: a b D Home Phone:
Owner's Authorized Agent: Work JL - ��� rn2 Work Phone:
Agent Address: 5&Ck,Q ��nj �`� City: `��� 1�i1✓
State: Zip Code:qoq(07 Agent Email Address: tl to \(a41[� G2""lY ce
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Escrow Company: r 1 C �� �—� �° Y O ! Escrow #:�
Escrow Address: d (� ( A b� '' 11 -ZHCity: F
State: ® Zip Code: o� 6 Escrow Phone: Q�
Email Report to:
For Inspection call (Name): 1 J j Direct Phone: ���'Z�
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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