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HomeMy WebLinkAboutR2021-0246 - Permit ApplicationDocuSign Envelope ID: 6C7EC53F-80084CFC-AD58-86465FE38929 City Of Newport Beach COMMUNITY, DEVELOPMENT DEPARTMENT BUILDING DIVISION 100,6VIC-Cebter Drive 1P.O - EIOx, 1168 Newport lfea6. CA 92658-8915 1 (949) 644-3260 RARM , V16 L 10 t% "I j,,V,GHVQj X' ; . I 00WOUNITY 1'jL'"-=L0PMEN1 APR 0 2 2021 GITY01 WofuP4. ffl,Addlrai' . I'll as:, Plbeis4tvbe or orbit and cothlaleto all information City:' Sate. ON zix, - --- -------------- ------ -- - - - Property Owner. MPLMONMF' 7PIK's"M."MRS, "M N --m-MMEMMMEM. Zkn Code - $tatbl!, Home, Phone, 0wn&s Atithofized Agent � Work Phone -a .551 Agent Adldrbss� N -Wyot me, iM HE ,P KIM,] City: A, Rim State: Zip Cod6, Agent Email Address: Escrow Comparir." Escrow Address: ;State;; Email Report t&. In 0, K. MHN --N 1-8 P., NMI gL For Inspection call (Name}-, il-MMIN 1�� - „_,,.F=.PIN Direct Phone: CONSENT TO INSPECr (FORM MUST BESIGNEDAND DATEDSELOW PicroUflt # bl(15050,4-52104,0.,.,.Make cheCk$p0y0bfe to CITYOFNEWPORTBEACH