HomeMy WebLinkAboutR2020-0285 - Permit ApplicationCity of Newport Beach ,,<>°cIVED ey
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION )EVELOPMENT
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 9265�1�2 2020
r ! www.newportbeachca.gov (949) 644-3200
RBR# 2 , 6.t D> CITY of
Application for Report of Residential Building Reoe;,dsr g�Pc1
Application Fee: $191.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_ Address: 916 East Oceanfront City: Newport Beach State: CA Zip: 92661
Property Owner: Groundswell Investments, LLC
Owner Address: - City:
State: Zip Code: - Home
Owner's Authorized Agent: Art White Work Phone:
Agent Address: 700 E. Balboa Blvd, City: Newport Beach State: CA Zip Code: 92661
Mobil Phone: (949) 673-9900 Agent Email Address:
Escrow Company: Mariners Escrow Escrow # 57943 -BF
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: bfoxcroft@marinersescrow.com
For Inspection Call (Name): _X_
City: Newport Beach
Escrow Phone: 949-640-6040
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Direct Phone:
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.
Owner or Agent's signature to authorize inspection
OR //�� I - `�
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Owner or Agent's signature to decline inspection d . C Dat :3 l2 - 2—
Account
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH