HomeMy WebLinkAboutR2020-0479 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENTc6IVELy 3�
BUILDING DIVISION COMMUNITY
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8QjjZ*EI.OPMEN7
www new ortbeachca ov I (949) 644-3200
JUN 18 2020
RBR#Applic'at'ion for Report of Residential Building RecordS3]TYOF
'I
Application Fee: $191.00 Notice: Applications wit tf�Tfkt ent fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please We or print and complete all information
# of Units: -1— Address:505 Poppy Avenue City: Newport Beach( Corona Del Mar Area) State: CA Zip:
92625
Property Owner: 505 Poppy. LLC, a California Limited Liability Company
Owner Address: - City:
State: Zip Code: - Home Pho
Owner's Authorized Agent: Timothy Tamura Work Phone:
Agent Address: 2720 E. Coast Highway, City: Corona Del Mar State: CA
Mobil Phone: - Agent Email Address: tim(o)valiaoc.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 # 58418 -BF
City: Newport Beach
Zip Code: 92625
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
Owner or Agent's signature to decline inspection
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH