HomeMy WebLinkAboutR2020-0478 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-80&1&-VEo a)
www.newportbeachca.gov 1 (949) 644-3200 COMMUNITY
7EVELOPMEN'1
RBR# )1 8 ?_1020
Application for Report of Residential Building RecoirdNs
Application Fee: $191.00 Notice: Applications with insu tcient fee
payment P%,c> RI 13G040�1
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: -1— Address:505.5 Poppv 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
Owner's Authorized Agent: Timothy Tamura Work Phone:
Agent Address: 2720 E. Coast Highway, City: Corona Del Mar State: CA Zip Code: 92625
Mobil Phone: - Agent Email Address: timOvaliaoc.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 # 58419 -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 Date:
n
Owner or Agent's signature to decline inspection
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH