HomeMy WebLinkAboutR2023-0480 - MiscRECEIVED BY
COMMUNITY
Print For City of Newport Beach DEVELOPMENT
COMMUNITY DEVELOPMENT DEPARTMENT MAY 3 12023
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915 CITY OF
ftw 9Zp 3 — p 4 gD www.newportbeachca.gov 1 (949) 644-3200 NEWPORT BEACH
Application for Report of Residential Building Records
Application Fee: - $202.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $134.00 or incomplete will be returned
Please type or print and complete
all information
# of Units:
Address: ,.... 419 1/2 Narcissus Avenue
City: Newport Beach.
State: A Zip: 92660
Property Owner.
CDM Properties, LLC
Zip Code: F—
Owner Address:
City:
State: CA
Zip Code: �—
Home Phone:
Owner's Authorized Agent:
Agent Address:
State: r— Zip Code: F
City:
Agent Email Address:
Escrow Company: Freedom Escrow
Escrow Address: 1200 Newport Center Dr., Suite 180
State: CA zip Code: 92 660
Email Report to:I mm@freedomescrow.com
For Inspection call (Name): I N/A
Work Phone:
Escrow #: 1 055835-MM
aty. I Newport Beach
Escrow Phone: 1 (949) 644-3939
Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOWI
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 /J �p
Owner/Agent's signature to decline /31/VLA ate:
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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