HomeMy WebLinkAboutR2021-0216 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISIONio2l QL� I n 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RSR# lY v. ww.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
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# of Units: ED Address: , .�j City: Newport Beach State: Fizip:
Property
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Owner Address: ( '% City.NuIV.
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Owner's Authorized Agent
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Email Report to:
For Inspection call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Paulthtrsize lmspectrons.andce=itsspertions'afthe prol5 rt steel above. I uryderstanid-thrat.if SbAding or Zoning.
vralatlor5sare discovered•I Wi0:be:resp6n. Weto correctsai'd vrnletians.
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Acmunt # 0105 05 0 4 5 21040 .............._.Make checks payable tn: CITY OF NEWPORT.BF417H
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