HomeMy WebLinkAboutR2020-0925 - Permit ApplicationDocuSign Envelope ID: B680E309-FA07-48F9-B98E-E587D68FE843
i f City of Newport Beach
m'.. COMMUNITY DEVELOPMENT DEPARTMENT @bNttU/UNIf`Y
BUILDING DIVISIONroEMs
i G�" i� 1 f�i-6ivic Center Drive I P.O. Box 1768 1 Newport Beach, CA926*111 �•
RBR# "�'`www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records''TYOF
Application Fee: - $184.00Notice: rr.�pf*Y ge,co
(For all Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $125.00 or incomplete will be returned
Please type or print and complete all information
#of Units: F'. Address: 1824 W. Oceanfront City: Newport Beach: State: CA ,Zip: 2663
Property Owner] Carol
J. Martin,Trustee
Escrow #: F7'
Zip Code: 92663
Owner Address:
1824
W. Oceanfront
City:
Newport Beach
State: CA
Zip Code: 92663
State:
Home Phone.
Owner's Authorized Agent:
92660
Escrow Phone:
Work Phone: 949.478.7781
Tara Shapiro
Agent Address:
1200 Newport Center Drive,
Ste .100 City:
Newport Beach
State: Fa
Zip Code: F9
Agent Email Address:tshapi
ro@homgroup. com
Escrow Company:
Escrow #: F7'
Ticor Title
-4
-
Escrow Address:
Po0 Quail Street, 3rd Floor
City:
Newport
Beach
State:
CA
F
Zip Code:
92660
Escrow Phone:
F714.289.3327
Email Report to:lkdhernandez@ticortitle.com tshapiro@homgroup.com
For Inspection call (Name): I N/A
Direct Phone: F
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections of the property listedabove. I understand that if Building or Zoning
violationsare discovered l will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection:
Date: I
OR
DocuSlgned by:
Owner/Agent's signature to decline inspection: �fi;- S(,iro Date: 10/21/2020
� 3354932C4595422_
Account # 0105OSO4-521040 .................Make checks payable to: CITY OF NEWPORT BEACH