HomeMy WebLinkAboutR2020-0824 - Permit ApplicationRBR# 11 I.
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City of Newport Beach cOMM(jNIT}'
COMMUNITY DEVELOPMENT DEPARTMENT `SEP 2
BUILDING DIVISION ReC0
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-891% OEVEL
www.newnortbeachca.gov 1 (949) 644-3200 X oPmeN),
Application for Report of Residential Building Records N�DRT o
Please type or print and complete all information
# of Units: 0 Address ;ZO,t62 �a ew A enue; t . City :.New p Beabh t 's Sate _G9 -E Zip:
Property Owner ..._,.,
,. ._..._,;Zip Code:
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Owner Address =: _, _,. �*'"` .:.rv. ��� �, '1 °d 3 City:
State Zip Code:
Home Phone:
Owner's Authorized Agent Nfike Kenned;'` Work Phone:
Agent Address:
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.::City:
State. (�
Zip Code 3 G64 ,, ;— ;!t
Agent Email Address:
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Escrow Company:A- rarttt,° ow.&:;SetC)ptpni.e ices `., ...., ..: x�Rx, Escrow #:
Escrow Address 4QNe `tsxftrlter',ueu�tem6QQ.___..; I.:._...._..e� City:
State: [fCA, Zip Code:
Email Report to:
Escrow Phone
For Inspection call (Name) qffi 0,50N Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH