HomeMy WebLinkAboutR2020-0346 - Permit ApplicationCity of he'wport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
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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:1859 Port Margate Place City: Newport Beach State: CA Zip: 92660
Property Owner: Gene R. Clark and Mario A. Clark
Owner Address: - City:
State: -Zip Code: - Home Phone:
Owner's Authorized Agent: Heather Kidder Work Phone:
Agent Address:
341 Bayside Drive. City: Newport Beach State:
CA
Zip Code: 92660
Mobil Phone: -
Agent Email Address: heather.kidderftcompass.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: bfoxcroft@marinersescrow.com
For Inspection Call (Name):
Escrow # 58160 -BF
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
Owner or Agent's signature to
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH