HomeMy WebLinkAboutR2021-0242 - Permit ApplicationPrint Form City of Newport Beach
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COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION VELOPMENT
�U2 I 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-89I
RBR# "[ www.newportbeachea.gov 1 (949) 644-3200 MW 312021
for Report of Residential Building Records
Notice:
I Applications with insu
Please type or print and complete all information
# of Units: �! Address: 2006 Port Weybridge Place City: Newport Beach , State: CA ',Zip: 92660
Propertyowner: Gregory Tennant and Laura Tennant Zip code:92660
Owner Address: 1 2006 Port Weybridge Place City: Newport Beach
_...
State: CA Zip Code: 92660 Home Phone:
Owner's Authorized Agent: Work Phone:
Agent Address: City:
State:, Zip Code: F Agent Email Address:
Escrow Company: First American Title Escrow #: LGL -6545778
Escrow Address: 207 Goode Ave. #410 City: Glendale
State: CA I Zip Code: 91203 Escrow Phone: 818-550-2553
I
Email Report to: I ehkim@firstam.com
For Inspection call (Name): Gregory Tennant and Laura Tennat Direct Phone: y� �� js �%U�
W-Zy`f P7ya
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning
violations are discovered I will be responsible to correct s
Owner/Agent's signature to authorize inspection: G ( Date: 2 91,9
—
OR
Owner/Agent's signature to decline inspection: Date:
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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