HomeMy WebLinkAboutR2020-0801 - Permit Application (2)DocuSign Envelope ID: DA25BC7A-4974-4EC8-B119-75EFD885B650
nt lrrr, =r City of Newport Beach
1 35
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
f/ID�(/U mq R �/L ry I 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
o l www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Application Fee: -$198.00 Notice`..
(For All Residential Buildings);. Applications with insufficient fee payment
Reinspection Fee $:131.00 or incomplete will be returned
Please type or print and complete all information
# of Units: Address: 206 Pearl Ave. City: Newport Beach State: CA ,,__Zip: 92662 _.._
Property Owner: 206 Pearl, LLC Zip Code:89135
Owner Address: 53 crested cloud way City: Las Vegas
`'
State:FV N v _� Zip Code:8913,5 Home Phone: (702) ,871-4569.__
Owner's Authorized Agent: Cole Tripp work Phone: 949-386-0821
Agent Address: 1301 Ventura Blvd. Suite 315 City: Sherman Oaks
State: FcA Zipcode: F91403 Agent email Address: cote@coineinvestmentgroup.com
Escrow,Company: Studio Escrow .Escrow#: 2388-B1
EscrowAddress: 1 15301 Ventura Blvd. B305 City: Sherman Oaks
State: CA Zip Code: 91403 Escrow Phone: 818-382-4120
Email Report to: francine@Studioescrow.com
For Inspection call (Name): tole Tripp Direct Phone: (949) 386-0821
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 l will be responsible tocorrectsaid violations.
Ba�slynea ey:
Owner/Agent's signatureto authorize inspection: y,',Tkff1Date: 11/16/2021
OR
Owner/Agent's signature to decline inspection:
Building Division\Forms\RBR_7-1-21
Date:
Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORTBEACH