HomeMy WebLinkAboutR2022-0310 - Permits (2)City of Newport Beach
C'��N[b
W;QJF�"QGNm
EVP opMENT
14 W1
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
1 DO Civic Center Drive 1 P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# www.newportbeachca.gov 1(949) 644-3200
ORT
Application for Report of Residential Building; Records
�i1�ll'frQF
G�
Please tvoe or print and complete all information
#of Units: ❑Address: - city: Newporteeach State: aTip:
Property Owner. ' � I' Zip Code:
Owner Address: F' ��% ��� 54, Gty: ('w ("� 7r. 3 G' ` 6
State: � Zip Code: L Home Phone: _
Owner'sAuthorized Agent(�12LL'-try Work Phoned ? q-.h.��_
Agent Address: 117t{�0 L'4L�3jGd�P rr7.Ur� Oh"• �i✓+�.eG�%-, .
State: C ^ Zip Code; Agent Email Address: dGCI,Uilk(�I-a(G1UUet(1 Ei< -cw
Escrow Compary: Granite Escrow Escrow#:=�� —�
FscrowAddresr. 450 Newport Center Dr #600 Cfty: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: 949-720-0110
Email Report to: tdarlin @ raniteescrow.com
For Inspection call (Name): Direct Phone:
1
CONSENT TO rNSPEQ' (FORM MUST BE SIGNED &DATED BIIOYIq
Account # 01050504-521040 _ ...............Make checks payable to: CITY OF NEWPORT BEACH
ewimos rc,®wtFmmwoR7-t-u