HomeMy WebLinkAboutR2020-0916 - Permit ApplicationDOouSign Envelope ID: A6B67AAA-B84D-4CBD-BEOB-07F4FE6EFABB
CITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION >P MUNITv
DLV100 Civic Center Drive P.O. Box 17681 Newport Beach, CA 92658-8915 ���!?
www.newportbeachca.gov 1 (949)644-3200 OCT 2 0 2020
RBR# P.2O20 —OGIco
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Application for Report of Residential Building Recordi,,.,Io,,-,
(Far All Residential Buildings) Application with insufficient fee payment a ment
Reinspection Fee $125.00 or incomplete will be returned
Please #vue or print and complete all information
Number of units. 33 Street Address: 2514 University Or
Property Owner. The Maruyams Family Partnership LLLP Zip Code: 92660
3 Rangeview wheat Ridge C0
Owner Address: ci 80215
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Home Phone:
303-238-1433
Work Phone:
Owner's Authorized Agent: KIM BREWER LUND, COLDWELL BANKER REALTY CALIFORNIA
Agent Address: 28051 GREENFIELD RD STE A, LAGUNA NIGUEL, CA
Work Phone:
Escrow Name and Address: West Coast Escrow, Escrow No. 4530420-09923 - TC
Escrow Address: 28051 Greenfield Drive # A, Laguna Niguel 92877 Escrow Phone: (949) 348-2777
Email Report to: terri.cordero@westcoastescrow com
For Inspection Cali (Name): NIA Phone: NIA
CONSENT TO INSPECT (FORM MUST BE SIGNED AND DATED BELOWI
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 I
Date C�
OR
Owner/Agent's signature to decline
Account #01050504-521040............ Make checks payable to CITY OF NEWPORT 9EACH"
Who to call for inspection? TO c-�, 't Q *3
Name: Direct Phone: