HomeMy WebLinkAboutR2022-0153 - Permit ApplicationDocuSign Envelope ID: 92EF4EC1-C777-4A20-8097-9A008F1EBD04
00`6O BP
COMMUNITY
DEVELOPMENT
Print Form City of Newport Beach
COMMUNITY DEVEBUILDINGLOPMENT DIVISION DEPARTMENT MAR 212022
,�WZL_ 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
RBR#K—� www.newportbeachca.gov 1 (949) 644-3200
CITY OF
Application for Report of Residential Building Recordat gEPG�
Application Fees: Single Family Res/Condo (1 unit) - $165.00 Notice:
Duplex (2 Units) - $192.00 Application with insufficient fee payment
More than 2 units - $192.00 + 11.00 per unit over 2 or incomplete will be returned
Reinsoection Fee $88.00
Please type or print and complete all information
# of Units: Address: 702 Saint James Place
Property Owner: The Palmer Family Trust
Owner Address:
State: CA Zip Code:
City: Newport Beach State: CA Zip: 92663
City:
Home Phone:
Owner's Authorized Agent: Steve High Work Phone:
r"y
Agent Address: 450 Newport Center Drive, suite 100 City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address: SHigh@VillaRealEstate.com
Escrow Company: Key Escrow, Inc.
Escrow # 006119-BR
Escrow Address: 450 Newport Center Drive, 230 City: Newport Beach
State: CA Zip Code: 92660 �N�SPB ('�-�-'^Escrow Phone: (949) 698-1960
Email Report To: brandi@keyescrow.com N
for Inspection Call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & 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 correct said violations.
Owner/ Agent's signature to authorize inspection:
Date:
Owner/ Agent's signature to decline inspection: Ffw.r. ; Date:
3/21/2022
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH