HomeMy WebLinkAboutR2020-0539 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT cc;Ng ;UlvlTr
BUILDING DIVISION }FVEI OPIENT
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# www.newportbeachca.gov 1 (949) 644-3200 itUN 3 0 ?O2a
Application for Report of Residential Building RecordsFv0F
Please type or print and complete all information
# of Units: IT] Address: 217 & 217.5 Topaz Aven7u7eT77] City: Newport Beach State: CA Zip: 92662
Property Owner: Raymond V. and Ramona W. Merle Trust Zip Code:
Owner Address: City:
State: CA Zip Code: Home Phone:
Owner's Authorized Agent: Work Phone:
Agent Address: City:
State. F 7 Agent EmailZip Code: � Address:
Escrow Company: Freedom Escrow Escrow #: 053803 -MM
Escrow Address: 11200 Newport Center Dr., Suite 180 ( City. I Newport Beach
State: CA Zip Code: 92660 _ Escrow Phone: (949) 644-3939
Email Report to: mm(C7treedomeSCrow.COm
For Inspection call (Name): N/A Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITY OFNEWPORTBEACH
Building_Division\Forms\RBR_9-18-18