HomeMy WebLinkAboutR2022-0048 - Permit ApplicationDocuSign Er. elope ID: 84012068-EF31-40E4-8475-98021851 E1A0 �CEIVEO Qp
COMMUNITY
DEVELOPMENT
JAN 31 2022
Print Form City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT CITY OF
BUILDING Box 17681 NN
�C11J�'(I -JUt (�14V670 Civic Center Drive I P.O. Box 1768 � Newport Beach, CA 92658-8915 .t1�
RBR# www.newporlbeachca.gov (949) 644-3200 4'°trpORT BE,Q.Ga
Application for Report of Residential Building Records
Application Fees: Single Family Res/Condo (tunit) - $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: 2601 Island View Drive
City: Newport Beach State: CA Zip: 92625
Property Owner: Sally Walsh Rhodes Residence Trust
Zip Code:
Owner Address:
City:
State: CA Zip Code:
Home Phone:
Owner's Authorized Agent: Michelle Linovitz
Work Phone: (949) 632-1618
Agent Address: 450 Newport Center Dr., Ste. 100
City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address:
Escrow Company: Key Escrow, Inc.
Escrow # 006051 -BR
Escrow Address: 450 Newport Center Drive, 230
City: Newport Beach
State: CA Zip Code: 92660
Escrow Phone: (949) 698-1960
Email Report To: brandi@keyescrow.com
for Inspection Call (Name): Direct
Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
violations are discovered I will be responsible to correct said violations.
Owner/ Agent's signature to authorize inspection:
understand that if Building or Zoning
Date:
Owner/ Agent's signature to decline inspection: Date:
1/28/2022
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH