HomeMy WebLinkAboutR2021-0776 - Permit ApplicationCOMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
K UUGI -01 � 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# K 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 Fees 131.00 or incomplete will be returned
Please type or print and complete all information
#of Units: Address: 1710 W. Oceanfront
City: Newport Beach State: CA z 663
Property Owner: uanita Bennett Zip Code: 2663
Owner Address: 1710 W. Oceanfront City: ewport Beach
State: CA Zip Code: 2662
Owner's Authorized Agent:
Agent Address:
State:
Zip Code:
Escrow Company: (peak Escrow
Escrow Address:1947 Camino Vida Roble
State:— Zip Code: 2008
Email Report to:
City:
Agent Email Address:
@ peakescrow.co M
Home Phone: 25-736-4181
Work Phone:
Escrow #: 04885 DL
City: arlsbad
Escrow Phone: 60-720-9900
For Inspection call (Name): �SaW ,`�U04" �� � Direct Phonel -315-9752
1 V512021 1:54:17 AM GMT
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/Agent's signature to authorize inspection:
Date:
OR
AufheMisws
�7057ZOZi'—
Owner/Agent's signature to decline inspection: )u<,,,;�n.eiunr�r,..7,.,.,rw;J,.�ur;ea:ete.r�u.e;r,uky:,.,.,e Date:7
I I1512021 2:10:46 AM GMT
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Bolding Division\Forms\RBR_7-1-21