HomeMy WebLinkAboutR2020-0848 - Permit Application"
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City of Newport Beach oC) ry
COMMUNITY DEVELOPMENT DEPARTMENT 'I RFw
BUILDING DIVISION C
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658 -8J18 -p F<op
www.newportbeachea.gov (949) 644-3200 0�1 "ENT
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Application for Report of Residential Building Records
Application Fee: $194.00 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:_ Address:1723 Port Abbey Place City: Newport Beach State: CA Zip: 92660
Property Owner: U/D/T Dated September 6 2001 F/B/O Acone Family Trust
Owner Address: 1723 Port Abbey Place
State: CA Zip Code: 92660 Home Phone:
Owner's Authorized Agent: For Sale By Owner Work Phone:
Agent Address: - City: - State: CA Zip Code:
Mobil Phone:
Escrow Company: Mariners Escrow
Agent Email Address:
Escrow Address: 270 Newoort Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: swelker@marinersescrow.com
For Inspection Call (Name):
City: Newport Beach
Escrow # 59216 -SW
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
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Owner or Agent's signature to decline inspectidn ; i . G'� /—� Date: / U ^V /- ca�-v
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH