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HomeMy WebLinkAboutR2024-0086 - Permit ApplicationCity of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY IVED Y BUILDING DIVISION DEVELOPMENT �7n �u 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-89VAR 18 2024 RBR# 1 G(/ L l - o�8,1� www.newportbeachda.gov 1 (949) 644-3200 CITY OF Application for Renort of Rpcirlpntiml o.,..,.,A- prr,.. __ # of Units: ❑ Address: Please type or print and complete all information VV1QI(&vK b. Okoip w kK1 PVUg1(l" City: Newport Beach State: FIZip: Owner Address; is- 1s City: State: CA Zip Code: . .V Fa 61 11aU N* Zip Code: b (A-k- Home Phone: Owner's Authorized Agent: E77Work Phone: Agent Address: City: State: Zip Code: Agent Email Address:-- Escrow Company: �) �% Escrow#: Escrow Address: 0 u � oVi IM1 -W 'om 1 City: uwf d✓j' State:�(J�. —bl�---� Zip Code: Fr `',_-I Escrow Phone: Email Report to: For Inspection call (Name): Bull ding_DIvislon\Forms\ggfl_615-23 VA Direct Phone: I CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)