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HomeMy WebLinkAboutR2020-0338 - 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.newportbeachce.gov 1 (949) 644-3200 RBR# Z©z 6 >3�C� 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:3528 Ocean Blvd City: Newport. Beach ( Corona Del Mar Area ) State: CA Zip: 92625 Property Owner: Anderson Living Trust, Dated April 1. 1973, as amended Owner Address: - City: State: -Zip Code: - Home Phone: Owner's Authorized Agent: Casey Lesher Work Phone: Agent Address: 840 Newport Center Dr. #100. City: Newport Beach State: CA Zip Code: 92660 Mobil Phone: - Agent Email Address: caseylesher gmail.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 # 58162 -DJ City: Newoort 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 Date: Owner or Agent's signature to decline inspection Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH )10