Loading...
HomeMy WebLinkAboutR2021-0448 - Permit Applicationtri-: E,SIVEIJ �?k City of Newport Beach COMMUNI�AIY� COMMUNITY DEVELOPMENT DEPARTMENT i)FvErQ�'MF13' ryUILDING DIVISION VIM 2 G�4100 Civic Center Drive P.O.P Box 1768 1 Newport Beach, CA92658L (�V�� RSR# �( www.newportbeachca.gov J (949) 644-3200 li Application for )deport of Residential Building Recor CITY /tnxiicatian Fie -$194.(713, Notice: (For AlIkesidentiai 863ldinss) Applications with insufficient fee Payment Reinspectich Fee $129.00 or itactrnaplete will be returned I #of Units: Address: i City: Newport Beach State: CA Zip % ,y Property Owner Address; State: CA Zip Code aat _._ �� f"aCvde: City: Home Phone s Owner's Authorized Agent; -_" ?i Work Phone: 4 T Agent Address 5_y k 4 city: State: Zip Code `! r mal Ad.d Agent Email Address; Escrow Company ��, " r� € ! Escrow# t� Escrow AddressIA- t" " �..�._..._. of ...E S"_,,,..�luy. _. :......F«.a_"„.._ .. ,. .-...._..... ._...._ ._._ _ ..1 State: _ j Zip Code i p , ?_d Escrow Phone: %` •a'�i Finail Report to , w c^ il )20 For Inspection call Narne : r t °� ) r t Direct Phone: CONSENT TO I,NSPECTIFORM MUST BE 5IGNECs_& DATED SELOW r Account ff 01050504-521040 ..... --.... .—Make checks payable to: CfPYOF NEWPOR TEACH �:dd�Jsu�sn,AFerns�R9fl-J mai} Il�� 111. CA/1.�nhA nOG9L07A09�f O�f�7-10A0�(lC(1F/17 A..11��C�'f