HomeMy WebLinkAboutR2021-0774 - Permit Application%Y City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISIONt�'S ;-
00 Civic Center Drive I P.O. Box 1768 Newport Beach, CA 92Q '019 RBR# Volt� www.newportbeachca.gov 1 (949) 644-3200 �' 3%1'`
NOV () 5 ?0Lj
Application for Report of Residential Building Records
Please type or Print and complete all information
# of Units: F7 Address: - y p f
212 29TH STREET Cit :New ort Beach State: CA zip 92663
Property
Owner Address: 212 29TH STREET
State: CA Zip code: 92663
?gmail.com zip Code:
City: NEWPORT BEACH
Home Phone. .
For Inspection call (Name):_.
—.__-.__ ; Direct Phone
-- I
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
violations are disc
Uwner/Agent's si
Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORTBEACH
9uilding Uvislon\Forms\qBR >-I-21