Loading...
HomeMy WebLinkAboutR2021-0486 - Permit ApplicationRECEIVzb City of Newport Beach co MINUNMe COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION JU` Q �00 Civic Center Drive P.O. Box 1768 Newport Beach, CA92658-8915 RFcd www.newportbeachca.gov 1 (949) 644-3200 Application for Report of Residential Building Recorder Please type or print and complete all information #of Units: © Address: 10'(,0 PO t CA;669e -City: Newport Beach State: [CTA a(p60 Property Owne r. SI &(01 MAes Zip Code: Cja�p�p� Owner Address: �_l(OO Pork 1Q P)GLC ( City:.... i I- .. State: L Zip Code: R26�o Home Phone: Owner's Authorized Agent: Work Phone: _-------------------- Agent Address: City: State:� Zip Code: C Agent Email Address: Escrow Company: 1"cee-6oyrn E$GyOW _ Escrow #: vJl17LIS' \-\ Escrow Address: �1ao(_ N ,Qorr_'�y\{{�,9r.__3�-1mCity: N2W OYk ec�c� State: Zip Code: RK7670 Escrow Phone: Email Report to: For Inspection call (Name): Direct Phone: CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW) Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORT BEACH Building DiWsian\Forms\RBR 2-30-20