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HomeMy WebLinkAboutR2022-0095 - Permit ApplicationPrint Form City of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY n BUILDING DIVISION DEVELOPMENT 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92PMI*2022 RBR# �" l ✓ www.newportbeachca.gov 1 (949) 644-3200 Application for Report of Residential Building RecorftIUF Application Fee: - $198.00 Notice: 4 PORT BFPO (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 9 I p state: CA Zip:F92625 # of Units: Address: 413 1/2 Marigold Ave City: Newport Beach Propertyowner:1 Patrick Enriquez Owner Address: I 413 1/2 Marigold Ave State: CA Zip Code: F92625 Zip Code: 92625 City: Corona Del Mar Home Phone: Owner's Authorized Agent: I Wayne Smith/Laura Quinn Work Phone: 949-836-0705 Agent Address: 13407 East Coast Hwy City: I Corona Del Mar State: -CA' Zip code: F92625 Agent Email Address: I laura@coronadelmarproperties.com Escrow Company: I First American Title Escrow #: 6781991 Escrow Address: 1 4 First American Way City: I Santa Ana State: CA Zip code: 92707 Escrow Phone: 714-250-4808 Email Report to: orangeescrowl@firstam.com For Inspection call (Name): ! Direct Phone: 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 to correct said violations .Owner/Agent's signature to authorize inspection: ..Date: OR 'Owner/Agent'ssignaturetodecline inspection: O Date; Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH BuIIE1ne_DIVI51on\Forms\RBR_7-1-21