HomeMy WebLinkAboutR2020-0841 - Permit ApplicationCity of Newport Beach RccF,
COMMUNITY DEVELOPMENT DEPARTMENT
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100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 SF o UN�r!
www newportbeachca gov 1 (949) 644-3200 2,9
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Application for Report of Residential Building Recordg�p FNr N
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Application Fee: $194.00 Notice: Applications with insufficient fee
payment
Reinsoection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: Address:2611 Bayshore Drive City: Newport Beach State: CA Zip: 92663
Property Owner: The Campbell Family Trust u/d/t March 16 1989
Owner Address: _ City:
State: Zip Code: - Home
Owner's Authorized Agent: Debi Bibb Work Phone:
Agent Address: 1200 Newport Center Drive. Suite 100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: - Agent Email Address: cibibb@homgroup com
Escrow Company: Mariners Escrow Escrow # 59334 -BF
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: bfoxcroft@marinersescrow.com
For Inspection Call (Name):
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
Owner or Agent's signature to decline inspection
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH