HomeMy WebLinkAboutR2023-0179 - Permit ApplicationCity of Newport Beach RECEIVED BY
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY DEVELOPMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915MAR 0 6 2023
# o ?,7 www.newl)ortbeachca.gov 1 (949) 644-3200
CITY OF
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Aptplication for Report of Residential Building Records NEWPORTBEkCH
Please type or print and complete all information
#of Units: [:E Address: I z105,Ccrsic6Drive 'D"-'-, city:
Sate: [�CK] zip:
Property Owner: Michael V. Rosenthal Zip Code:
Owner Address: 1: City:
State: = Zip Code:
Home Phone:
Owner's Authorized Agent: -L! Work Phone:
Agent Address:
1::4 Corporate Plaza Suite 100
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I city:
State: [CA ?
Zip Code:
Agent Email Address:
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Escrow Company: Granite. Escrow & Settlement Services "7 '1 Escrow #: 1, 0447737-JJQ
Escrow Address: I- 450:,New poit Cehfdr Orivie,' Suite 600:--1 City: li Newpoit:Be
State: [:GA :' Zip Code: Escrow Phone: 1 (9491720- 1101
Email Report to: scrow:com,�;:�:,�
jd6miellby@granitee A
For Inspection call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW)
Account # 01050504-521040 ..................Make checks payable to CITY OF NEWPORT BEACH
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