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HomeMy WebLinkAboutR2024-0012 - Permit ApplicationPrint Form City of Newport Beach RECEIVED By COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY BUILDING DIVISION DEVELOPMENT n 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA99jWe0%)jR?4 RBR#'L�y' 0��2 www.newportbeachca.gov 1 (949) 644-3200 CITY OF Application for Report of Residential Building RecowdsTBEACH Application Fee: -$208.00 Notice: (For All Residential Buildings) Applications with insufficient fee payment Reinspection Fee $138.00 or incomplete will be returned Please type or print and complete all information #ofUnits: I ' Address: 2015 Yacht Vindex City: Newport Beach State: CA Zip: 92660 Propertyowner: Carol LaFourcade .Robinson Zip Code: F92660 Owner Address: City: 2015 Yacht Vindex Newport Beach State: CA Zip Code: F92660 Home Phone: 760 835 0922 Owner's Authorized Agent: Work Phone: Jeanne LaFourcade 714 745 4957 Agent Address: City: 12665 Stanton Avenue Tustin State: C Zip Code: 9� Agent Email Address: JeanneLafoucade@gmail.com Escrow Company: Escrow Technologies Escrow Address: 5000 Birch St, Suite 3000-352 State: Ca Zip Code: 92660 Email Report to: Terri@escrowtech.net For Inspection call (Name): Escrow #:I N24-00860-TE City: Newport Beach Escrow Phone: 1949-945-291 4 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 will be responsibleto correct said violations. Owner/Agent's signature to authorize inspection: Date: OR Owner/Agent's signature to decline / L+L Date: Account # 01050SO4-S21040 _ __ _ __. _ _. Mnka r•hor•kc nnvnhlo to • [I OF NFWDART RF4[N Build1ng_D1Ws1on\Forms\RBR_&15-1 TV ch / ®®®g'infV atisreal [ima 5000 Birch Street, Suite 3000-352 West Tower • Newport Beach, CA 92660• Tel: (949) 390-5828 January 8, 2024 City of Newport Beach 100 Civic Center Drive Newport Beach, Ca 92660 Attn: Building department Property: 2015 Yacht Vindex, Newport Beach Enclosed is the Check in the amount of $208.00 and Residential Building report signed. Sincerely Terri Eden Escrow Officer Del enclosed