HomeMy WebLinkAboutR2020-0838 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 gcelvFU
www.newportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Records SEP 24 r ~;
Application Fee: $194.00 Notice: Applications wit 45414nt,fee,
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Reinspection Fee $ 129.00 or incomplete will be �kUrned:S
Please type or print and complete all information
# of Units: -2— Address:204 & 204 1/2 South Bay Front City: Newport Beach State: CA Zip: 92662
Property Owner: The Robert O Kupper and Cynthia C. Kupper Family Trust dated November 14, 1988
Owner Address: - City:
State: -Zip Code: - Home
Owner's Authorized Agent: Mary Hardesty Work Phone:
Agent Address: 108 Agate Avenue, City: Balboa Island State: CA Zip Code: 92662
Mobil Phone: - Agent Email Address: maryrealty@sbcglobal.net
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: bfoxcroft@marinersescrow.com
Escrow # 59306 -BF
City: Newport Beach
Escrow Phone: 949-640-6040
For Inspection Call (Name): 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
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Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH