HomeMy WebLinkAboutR2020-0530 - Permit ApplicationCiti(' of Newport Beach a,.
COMMUNITY DEVELOPMENT DEPARTMENT COWALINITv
BUILDING DIVISION )r:v l onn�r:r r
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-891N 0 2020
www.newportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Recordl
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Application Fee: $191.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
3 Please type or print and complete all information
# of Units: Address:3207 Bayside Drive City: Newport Beach ( Corona Del Mar Area ) State: CA Zip:
92625
Property Owner: The Kopecky Family Trust dated March 22 2000 and The Laura Figueroa Trust dated May 20 2016
Owner Address: - City:
State: -Zip Code: _ Home Phone:
Owner's Authorized Agent: ,left Ewing Work Phone:
Agent Address: 840 Newport Center Drive #100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 275-0022 Agent Email Address: ieffrewing@coldwellbanker.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: bfoxcroft@marinersescrow.com
For Inspection Call (Name):
Escrow # 58550 -BF
City: Newport Beach
Escrow Phone: 949-640-6040
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 or Agent's signature to authorize inspection Date:
Ko
Owner or Agent's signature to decline inspection
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH