HomeMy WebLinkAboutR2024-0132 - Permit ApplicationCity of Newport Beach RECEIVED BY
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION DEVELOPMENT
�1 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA9261:���1� 2024
RBR# 1�2UZK'D132. www.newportbeachda.gov 1 (949) 644-3200
Application for Report of Residential Building Recoli of
Please type or print and complete all information
# of Units: ❑ Address: I �� " \�� City: Newport Beach State: Zip:
Property
Owner Ac
State: CA
Zip Code: IA1
Zip Code: v6
Home Phone:
Owner's Authorized Agent: I- Work Phone:
Agent Address: City:
State: Zip Code: Agent Email Address:
Escrow Company: v& Escrow #: U
Escrow Address: I Igo MW - (� City: .0
State: Zip Code: LJ Escrow Phone: h��ItJ- I" ►' 1
Email Reportto: VV aW -
For Inspection call (Name): Direct Phone: I
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITYOF NEWPORT BEACH -
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