HomeMy WebLinkAboutR2020-0951 - Permit ApplicationDocuSign Envelope ID: C005AC10-EBE3-4127-AA36-14F819BB813B
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Print Form City of Newport Beach
COMMUNITBUILDI DEVELOPMENT DIVISION DEPARTMENT -.�Ap �'�
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-891 1111 ���
RBR# Ot.S 1, www.newportbeachca.gov 1 (949) 644-3200 4� OO
Application for Report of Residential Building Records
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
Reinspection Fee $88.00
Please type or print and complete all information
# of Units: Address: 1018 Nottingham Road City: Newport Beach State: CA Zip: 92660
Property Owner: Sherri W.
Owner Address: 2251
State: PA
Mail Road
Zip Code: 19006
City: Huntingdon
Home Phone:
Owner's Authorized Agent: AJ Olson Whitfield Work Phone:
Zip Code:
Agent Address: 450 Newport Center Drive, suite 100 City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address:—Awhitfield@villarealestate.com
Escrow Company: Key Escrow, Inc.
Escrow Address: 450 Newport Center Drive, 230
State: CA Zip Code: 92660
Email Report To: brandi@keyescrow.com
for Inspection Call (Name):
Escrow# 005042 -BR
City: Newport Beach
Direct Phone:
Escrow Phone: (949) 698-1960
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
or
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: Date:
11/14/2020
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH