HomeMy WebLinkAboutR2021-0439 - Permit ApplicationOfMeNT
City of Newport Beach i0N 1_6 ?029
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
gyp 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR4
wiArw.newiportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Records
City SateZip:
#of Units: Address:
C
�'fl y:-- ty:92661
Property Owner:
Owner Address:
City:
State: = Zip Code: Home Phone. ss
Owner's Authorized Agent: �,::F T IF
..... .. Work Phone:
Agent Address:
State: CA. ' Zip Code:
Agent Email Address:
City:
Zip Code:
For Inspection call (Name): I I Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOW
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH