HomeMy WebLinkAboutR2020-0505 - Permit Application (2)Print Form71 City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR# p{ JS(us S www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Application Fee: -$3.91.00 Notice:
(For All Residential Buildings) 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: 2230 Newport Hills Drive East City: Newport Beach State: CA Zip: F92660
Property Owner: Pepperdine University, a California non-profit corporation Zip Code: 90263-7500
Owner Address: , 24255 Pacific Coast Highway City: I Malibu
State: CA Zip Code: 90263-7500 Home Phone: F N/A
Owner's Authorized Agent: harles J. Pippin, Sr. Vice President & C.1.0 �Work Phone: F310-506-4000
Agent Address: 24255 Pacific Coast Highway City: ( Malibu
State: CA Zip Code: 90263-7500 Agent Email Address: jeff.pippin@pepperdine.edu
Escrow Company: I Corner Escrow, Inc. Escrow #: 109 -9647 -SC
Escrow Address: 124310 Moulton Parkwat, Suite E City: I Laguna Woods
State: FCA Zip Code: F2637 Escrow Phone: 949-767-0009
Email Report to: I Stacy@cornerescrow.com
For Inspection call (Name): Charlie Schutz Direct Phone: 310-601-0372
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/Agent's signature to authorize inspection:
Pepperdine University, Inc. by:
OR
Pepperdine University
Owner/Agent's signature to decline inspection:
Date:
Date:
Account # 01050504-521040 .................Make checks payable to: CITYOF NEWPORT BEACH
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