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Home My WebLink AboutR2020-0249 - Permit ApplicationDocuSign Envelope ID: 525B06E0-8918-4447-BF73-01730CB79979 Print Forst, City of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION ry� ®®®®1�00 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 RBR# 20 -CZ°yg www.newportbeachca.gov 1 (949) 644-3200 0 Application for Report of Residential Building Records Application Fee: -$191.00 Notice: (For All Residential Buildings) Applications with insufficient fee payment Reinspection Fee $129.00 or incomplete will be returned Please type or print and complete all information # of Units: F -i— Address:211 39th St Property Owner:l George Applebaum Owner Address: 211 39th St state: CA zip code: 92663 City: Newport Beach State: CA Zip: 92663 Zip code: F92663 City: FNewport Beach Owner's Authorized Agent: I Carl Ciapltano Agent Address: 1303 3rd St, Ste 200 City: State: CA Zip Code: F92648 Agent Email Address: Escrow company: IPalomares Escrow Home Phone: 909-322-6882 Work Phone: 1 714-625-8767 Huntington Beach carl@caricapitano.com Escrow #: 134835 EscrowAddress: 1425 W. Foothill Blvd, Suite 230 City: I Upland State: Fi5A Zip Code: FgT786 Escrow Phone: 1 909-946-5694 Email Reportto: lorl@palomaresescrow.com For Inspection call (Name): I Carolyn Woodley Direct Phone: I 949-325-4613 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 responsible to correct said violations. by! Owner/Agent's signature to authorize DocuBlgned by: Owner/Agent's signature to decline inspection: 3/16/2020 BFCCCBEME8EEE3... Account # 01050504-521040 .................Make checks payable to: CITYOF NEWPORT BEACH Building Division\Forms\RBP 918-18