HomeMy WebLinkAboutR2020-0283 - Permit ApplicationCity of Newport Beach GeNED 81,
COMMUNITY DEVELOPMENT DEPARTMENT 60MMUNITY
BUILDING DIVISION wVrI..0PMCN3
100 Civic Center Drive i P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644.3200 12 70
RBR# ZZOZ -- C )
Application for Report of Residential Building Recorcl&ayOF
- - Os
Application Fee: $191.00 Notice: Applications wi4hfin uif Cckent fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or Print and complete all Information
# of Units:— Address:3251/2 Marguerite Avenue City: Corona Dei Mar State: CA Zip: 92625
Property Owner:
Sally
E. Anderson Trust Dated
July 26, 2001
Owner Address:
325
1h Marguerite Avenue
City: Corona Del Mar
State: CLQ Zip Code: 92625 Home Phone:
Owner's Authorized Agents Carter Kaufman Work Phone:
Agent Address: 110 Broadway, Suite B, City: Costa Mesa State: CA Zip Code: 92627
Mobil Phone: - Agent Email Address:
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: swelker@marinersescrow.com
For Inspection Call (Name):
Escrow # 57937 -SW
City: Newport Beach
Escrow Phone: 949.640-6040
Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED tk 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 or Agent's signature to authorize inspection Date:—
Owner
ate:
Owner or Agent's signature to decline inspection
11�7R
Date: 3 12 IJIW
Account # 2900-5005 ................. Make checks payable to OTY OF NEWPORT BEACH