HomeMy WebLinkAboutR2021-0613 - Permit ApplicationF City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
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15 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR# ,VIC L lX J www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Application Fee: - $198.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $131.00 or inoompl@tg will 6e returned
Please type or print and complete all information
# of Units: Address: ✓.�VE / City: Newport.Beach, State: CA ,!Zip: lc7W
Property
Zip Code:
Owner Address:
State: F777 Zip Code: q
Email Report to: 1/&�'®(/-f7N�........ __..
For Inspection call (Name): _._. N._..1! ., ,l Direct Phone
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
BuildinggDlvislon\Forms\RBR 7-1-21