HomeMy WebLinkAboutR2020-0333 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive f P.Q. Box 1758 i Newport Beach, CA 92558-8915
www.newportbeachca.gov 1 (949) 644-3200
RSR# Z 2 � — o'`'3
Application for Report of Residential Building Records
Application Fee: $191.00 Notice: Applications with Insufficient fee
payment
Reinspection Fee $129.00 or incomplete will he returned
# of Units:_1_ Address:315.5 Goldenrod Avenue City: Corona Del Mar State: CA Zip: 92625
Owner Address: 3101 State Road City: Bakersfield
State: CA Zip Code: 92208 Home Phone:
Owner's Authorized Agent: Steven Sergi Work Phone: (949) 573-0789
Agent Address: 2720 E. Coast Highway, City: Corona Del Mar State: CA Zip Code: 92625
Mobil Phone: (949) 292-6545 Agent Email Address: steven(dtvallaoc.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive. Suite 200
State: CA ,Zip Code: 92660
Email Report To: bfoxcroft@marinersesorow.com
For Inspection Call (Name);
Escrow # 58134-8F
City: Newoorl Beach
Escrow Phone: 949-640-6040
Direct Phone:
�1•J\C� i 1.. � i� �L � i: i i I: 5:11'/�
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 Date:
Owner or Agent's signature to
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH