HomeMy WebLinkAboutR2022-0019 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
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www.newportbaachca.gov1(949)644-3200
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Property
Owner Address: l _:;(/"
State: Zip Code:
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Home Phone: R 10 2 U t- 0
owner's Authorized Agent: U .Q/ Work Phone: & q"L 7/1V101 --o ^
Agent �Address:
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State: L-,-u-d-- J Tap Code: Agent Email Address: I� 1
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Email Report
For inspection call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
rautharke inspectrorns.andra�ibspectiornsaf••the property fisted above. l understarid-that.ff Building or Zoning.
vralations are-discovered:l Wiff be:responsibtk- to correctsafd violations.
Dwner/AgFnt`.ssignature•to•author<ie•lnspecti'am: Date..—
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Dwner/AgenC'ssigmatur*todeciioe.inspectibm: Date'. pZ'L
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