HomeMy WebLinkAboutR2021-0577 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
? 100 Civic Center Drive P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# C www.newportheachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
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# of Units: 117, Address: Q -M V Cc5co'rvsa 1 City: Newport Beach State: FCA Zip: �I2-lQlQp�
Property Owner: cede}('\rr uy�\S '{'h4 Zip Code:
Owner Address: City:
State: Zip Code: �I Home Phone:
Owner's Authorized Agent:
Agent Address: i City -
State: F7777 Zip Code: Agent Email Address:
Work Phone: I
Escrow Company: �,��,y� C9cy�f�- -3
Escrow oc:Y-ViS
FscrowAddress: lo`lUU rJ(ra..1 �Orc cec,-lev T,")V . t-kvJv,�- %ectc� !
State: " Zip Code: C2C u Escrow Phone:
Email Report to: 7u�K-r5C�rC (_Cm•� w �rlleSe.,�ow•Ccxn
For Inspection call (Name): ly'Irj- Direct Phone: _ I`I ' !
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CONSENT TO INSPECT IFORM MUST BE SIGNED S DATED BELOW)
Account #01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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