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HomeMy WebLinkAboutR2020-0326 - Permit ApplicationCity of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 www.newportbeachca.gov 1 (949) 644-3200 RBR# V__,��ozp 6 Application for Report of Residential Building Records 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: -1— Address:310 Anade Avenue City: Newport Beach State: CA Zip: 92661 Property Owner: Andrew Cogliano Owner Address: - City: State: -Zip Code:- Home Owner's Authorized Agent: Jon -Paul Bell Work Phone: (949) 554-1272 Agent Address: 1200 Newport Center Drive Suite 100, City: Newport Beach State: CA Zip Code: 92660 Mobil Phone: - Agent Email Address: jpbell0pacificsir com Escrow Company: Mariners Escrow Escrow Address: 270 Newport Center Drive, Suite 200 State: CA Zip Code: 92660 Email Report To: djohnson@marinersescrow.com For Inspection Call (Name): Escrow # 58115 -DJ City: Newport Beach Escrow Phone: 949-640-6040 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 responsible to correct said violations. Owner or Agent's signature to authorize inspection OR �q� 9 9 p vC�v�"�� Owner or Agent's signature to decline ins a ion e: Account # 2900-5005 .................Make -checks payable to CITY OF NEWPORT BEACH JL'i cti L