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HomeMy WebLinkAboutR2020-0505 - Permit ApplicationREVISED City of Newport Beach �ulvel' 1 Priv# Form • r a - COr,_c\ ' C>MMUfIITY COMMUNITY DEVELOPMENT DEPARTMENT i)EVEI.OPMEN7 BUILDING DIVISION 00 Civic Center Drive P.O. Box 17681 Newport Beach, CA 92658* 2020 RgR# www.newportbeachea.gov 1 (949) 644-3200 Application for Report of Residential Building Recogiscarr or- Anolication Fee: -$191.00 Notice: (For All Residential Buildings) Applications with insufficient fee payment Reinspection Fee $129.00 or incomplete will be returned Please type or print and complete all information # of Units: r 1 Address: 2230 Newport Hills Drive East City: Newport Beach State: [CA Zip: 92660 PropertyOwner] Pepperdine University,. a. California non-profit corporation Zip Code: 90263-7500. Owner Address: 24255 Pacific Coast Highway City: Malibu State: CA Zip Code: 90263-7500 Home Phone: N/A Owner's Authorized Agent: harles J. Pippin, Sr. Vice President & C.LO Work Phone: 310-506.4000 Agent Address: 24255 Pacific Coast Highway City: Malibu State: C'' Zip Code: 90263-7500.- Agent Email Address: jeff.pippin@pepperdine.edu Escrow Company: Corner Escrow, Inc. Escrow H: 09 -9647 -SC Escrow Address: ( 24310 Moulton Parkwat, Suite E State: F Zip Code: F92637 City: Laguna Woods Escrow Phone: 949-767-0009 Email Report to: I _stacy@cornerescrow.com For Inspection call (Name): Charlie Schutz Direct Phone: 310-601-0372 CONSENT TO INSPECT (FORM MUST BE S16NED & DATED BELOW I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning violations are discovered I will be responsible to correctsaid violations. Owner/Agent's signature to authorize inspection: Pepperdine University, Inc. by: X 10 Pepperdine University Owner/Agent's signature to decline inspection: Date: F Date:r Account ff UIUSUSU4-521U4U .................Make checks payable to: CITY OF NEWPORT BEACH BuiWIn0._Oivislon\Formsl0.Bft_9]&]e