HomeMy WebLinkAboutR2023-0213 - Permit ApplicationRECEIVED BY
Print Form City of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION MAR 15 2023
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
39W gm 3 - O Z-k www.newportbeachca.gov 1 (949) 644-3200 CITY OF
NEWPORT BEACH
Application for Report of Residential Building Records
Application Fee: - $202.00 Notice:
(For AIIResidential Buildings) Applications with insufficient fee payment
Reinspection Fees 134.00 or incomplete will be returned
Please type or print and complete all information
# of Units: F Address: 1 20352 Bayview Drive
PropertyOwner:I The Asher Family Revocable Trust
Owner Address:
State: I-' Zip Code: F—
Owner's Authorized Agent:
City: Newport Beach State: CA Zip: 92660
Zip Code: �—
City:
Agent Address: City:
State: Zip Code: F Agent Email Address:
Escrow Company: I Freedom Escrow
Escrow Address: 11200 Newport Center Dr., Suite 180
State: FCA Zip Code: 92660
Email Report to: I mm@freedomescrow.com
For Inspection call (Name): N/A
Home Phone:
Work Phone:
Escrow #: 055733-MM
City: I Newport Beach
Escrow Phone: 1 (949) 644-3939
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 I wil I be responsible to correct said violations.
Owner/Agent's signatureto authorize inspection: Date:
/ / ��OR�� ,/ /
Owner/Agent's signature to decline 211APGtGx->�i�t�-r fY�lln>it SYA6E�Date: O3. J32�
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Building Biuision\Forms\RBR_6-15-22