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HomeMy WebLinkAboutR2022-0150 - Permit ApplicationCity of Newport Beach �,eCEIVED ey COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY49 BUILDING DIVISION DEVELOPMENT 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 RBR# ( � „\,,,Z— ftO www.newnortbeachca.aov 1 (949) 644-3200 MAR 2 12022 � Application for Report of Residential Building Records CITYOr- Please type or print and complete all information # of Units: r�r'� Address 7 " M ,fly_:;:. �'t�l... it Vie. ° ��� + °4+ Cit � w 4 e u�,�e � a= ,a... Y� :civ . o,�- aciat Sate °r� ZiP• 119ORM n67,is.* Property Owner kj)I) bisr4i#ee faf #fie Plj BEY IUIN"f�US (r establjhaj Zi Code P Owner Address ;, . 5 Cit State Zip Code v t „ . s „ Home Phone:i3 +am + a Owner's Authorized Agent dPli,C,auiuv`. sr =, r,=ryn.k + ,a s t,:Ga 4 n E,a„w Work Phone Agent Address flI90 hj,� . artntPb, r{ue ar. it!t09 City IttiPerf'�ph ' State G,: s: Zip Code. ;=9. 4iDa„ S s M ._. ” Agent Email Address: .�_'. ,. r Escrow Company E.e:, Escrow#:4:m.ti5r3 Escrow Address 4 CY Q_ > e derte;Pf2 s City: NfdjPli` ectfix State{ = Zip Codeiti0r, n€ , Escrow Phone: Email Report to jt�ahhgl(ytptanitEE&ToW.jxpm For Inspection call (Name) r Direct Phone: CONSENT TO INSPECT IFORM MUST BE SIGNED AND DATED BELOW BuiJding_Division\Forms\RBR 7-1-21