HomeMy WebLinkAboutR2020-0299 - Permit ApplicationGGNED 81,
Print Form City of Newport Beach c, scnunnzY
COMMUNITY DEVELOPMENT DEPARTMENT r prAEM13�
BUILDING DIVISION i�aR �,) Z®��
��//�, 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR#Z'ZO ZO — Cl ZGj l www.newportbeachca.gov ( (949) 644-3200 ;qclF
Application for Report of Residential Building
Application Fee: - $191.00
(For AR Residential Buildings)
Reinspection Fee $129.00
Notice:
Applications with insufficient fee payment
or incomplete will be returned
Please type or print and complete all information AP fi 936 — `V60— �j9
# of Units: Address: /f Harbor Ridge Drive CRY: Newport Beach , State: �CA !,Zip: 92660
Robert W. Egger and Rebecca A. Egger
Owner Address: 1 43 Harbor Ridge Drive
State: (CA Zip Code: F92660
Zip Code: 92660
City: I Newport Beanch
Home Phone: f (949) 874-4020
Owner's Authorized Agent: Mina Maghami Work Phone: 949-874-4020
Agent Address. I Padfic Sc!,aby's ritemaft.r.0Roakv 120 Ne%:p--1 Cenlv, Dwe 0-103 City: Newport Beach
State: CA Zip Code: 92660 Agent Email Address: Fminamaghami@gmail.com
Escrow company: CORNER ESCROV! Escrow It: 08-9168-vk
EscrowAddress: 1 18600 MacArthur Blvd #350
State: L. CA _:.._ Zip Code: 1_. 92660)
Email Report to:' Vesna.kopaC@COrnerescrow-corn
For inspection call (Name): I Mina Maghami
City: I ii -vine
€scrow Phone:' 949-800-8908
Direct Phone: 949-874-4020
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections of the property listed above. l understand that if Building or Zoning
violations are discovered I will be responsible to correct said violations.
Owner/Agent's signatureto authorize inspection: �--Date: F5 - l `�- Z�o
OR
Owner/Agent's signature to decline inspection:
B.ftn,Div�XF.ARSRy19.19
Date:
Account # 01050504-521040 .................Make checks payable to: CtTYOP NEWPORT BEACH