HomeMy WebLinkAboutR2020-0918 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT ;
BUILDING DIVISION "Omm. i Ulla
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K] cr 100 Civic Center Drive P.O. Box 1768 1 Newport Beach, CA9265�415
RBR# 2o2(7 - y A I o www.newportbeachca.gov 1 (949) 644-3200 0 C T 2 12070
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#ofUnits: Address: 715 Bayside Drive City: Newport.. Beach �I� State: CA .........Zip: 92660
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Property Owner: Gregson B. Hall Irrevocable Trust, Dated January 1, 1989 Zip Code:92660
Owner Address: 715 Bayside Drive City: Newport Beach
State: CA Zip Code: L92660 Home Phone: F_
Owner's Authorized Agent: Work Phone:
Agent Address: City:
State: Zip Code: F Agent Email Address:
Escrow Company: Freedom Escrow Escrow #: 054131–MM
Escrow Address: 1200 Newport Center Dr. # 180 City: Newport Beach
- - — --- ----. _.._.
State: CA Zip Code 92660 Escrow Phone: 949-644-3939
Email Report to: mm@freedomescrow.com
For Inspection call (Name): ,l Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections ofthe property listed above. I understand that if Buildingor Zoning,
violations are discovered i will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection: Date:
MAIC
Of it � (� n�
Owner/Agent's signature to decline inspection: MAIC 4 ") ti�lUdt�e Date:
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Building Dmv ,on\Farms\RBR 7-30-20