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HomeMy WebLinkAboutR2020-0340 - Permit ApplicationCity of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 RBR# ,Ay 0 www.newportbeachca.go 1 (949) 644-3200 Aplication for Report of Residential Building Records Please type or print and complete all information #of Units: M Address: j66,j�A h City: Sate: [W zip: .1401r.0i � Property Owner: DThe:86thl Zip Code: Owner Address.J.--% flbv'ef,",fr, City: Agent Address: State: Zip Code: jlv- Home Phone: State: [7CAs ,.; u. n Agent Email Address: Owner's Authorized Agent: Work Phone: Agent Address: City;: jlv- State: [7CAs ,.; Zip Code: Agent Email Address: Escrow Company:R Escrow #:04424q i 71G ,,, Escrow Address: A450 )i -port d N City OW -.130t' State: Zip Code: Escrow Phone: n -ET T Email Report to: 1` 21 - For Inspection Gall (Name): JMH2MM R115 IN Direct Phone: CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH