HomeMy WebLinkAboutR2023-0619 - Permit ApplicationRECEIVED BY
Print Form City of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION 5y 89
100 Civic Center Drive I P.O. Box 1768 Newport Beach, CA926- 1 2023
RBR# 12-2023 — pf9 11 www.newportbeachca.gov (949)644-3200 CITY OF
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: F Address: 250PoppyAve
Property Owner:) The RonaldH. Agins Revocable Trust dated3130194
Owner Address: 250 Poppy Ave
State: CA Zip Code: F2625
Owner's Authorized Agent: I Paula Aragone
Agent Address: 4 Corporate Plaza #100
State: CA Zip Code: F92660
City: Corona Del Mar. State: CA Zip: 92625
City: I Corona Del Mar
Home Phone:
Work Phone: 1 714-366-6117
City: I Newport Beach
Agent Email Address: I paula@aragoneassoc.com
Zip Code:
Escrow Company: Coast Cities Escrow Escrow #: 30.15271-wi
Escrow Address: 18200 Yorba Linda Blvd., #201 City: FYorba Linda
State: FCA Zip Code: F92886 Escrow Phone: 714-579-7300
Email Report to: Wiwanaga@coastcitiesescrowcom
For Inspection call (Name): Direct Phone: �—
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
[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
Owner/Agent's signature to decline Date: ��� 23
Account It 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Building Division\Farms\RBR_6-15-22