HomeMy WebLinkAboutR2021-0813 - Permit ApplicationME City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Please type or print and complete all information
#of Units: 1❑ Address: 407 Heliotrope Avenue City: Newport Beach State: [CA Zip: 92625
Property Owner: Deborah Fraser Zip Code:
Owner Address: F City:
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State: CA Zip Code: Home Phone:
Owner's Authorized Agent: �— Work Phone: �—
Agent Address: City:
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State: I — ! Zip Code: Agent Email Address:
Escrow Company: Freedom Escrow Escrow#: 055029 MM
Escrow Address: 11200 Newport Center Dr., Suite 180 City: I Newport Beach
State: Cq Zip Code: 92660 Escrow Phone: (949) 644-3939
Email Report to: mm@freedomescrow.com -
For Inspection call (Name): I N/A Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Hui lding p1v1sion\Forms\R13R_7-1- 21