HomeMy WebLinkAboutR2020-0849 - Permit ApplicationIIECEIv,®
City of Newport Beach COA4441j
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COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 i Newport Beach, CA 92658-8915n OF
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ry X020 ' OS"l q www.newoortbeachca.¢ov 1 (949) 644-3200
Application for Report of Residential Building Records 4�PORT eep
# of Units: M Address:
Property Owner:
Please type or print and complete all information
City: ;Newort`Beach Sate CA; Zip ;92866 .
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Owner Address _
State: Zip Code:
Home Phone:
Zip Code:
Owner's Authorized Agent: [ Jdhhny Wighaisn Work Phone • .> j
Agent Address. ]8011ew .4r# t7ternRr, S#e ,27OrE, ,, E m, City 'Ne oiti]8each
State. � Zip Code:
Agent Email Address k kticFih Corn , r ,
Escrow Company: mte:'Escroq 990A"4-86 4 r Escrow # (14 434Z6..TLG .. _....':
Escrow Address 480New•oTtCentet_'t]'r.'.N_,�,SuI#e;$0(1 _,r" :,a €°P
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State =A .,; Zip Code e928&D r..=:: _y,,,; Escrow Phone:
Email Report togrxifori@yF3fjrteEgCrbWCom c ")
For Inspection call (Name) .._,. m ._.iffiDirect Phone
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH