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HomeMy WebLinkAboutR2021-0175 - Permit ApplicationCITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT a�°OVEr' `'Y" BUILDING DIVISION COMPJUNITY ;��rT ME 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 9265$=r 89T5 www.newportbeachca.gov 1 (949)644-3200 MAR 0 $ 2021 RBR# �VU�9"V�� 0TY Of - Application for Report of Residential Building Records'iFwp©r�T Application Feet $194.00 Notice: (For All Residential Buildings) Application with insufficient fee payment Reinspection Fee $125.00 or incomplete will be returned Please type or print and complete all information Number of units: Street Address: 1417 West Bay Avenue Property Owner: Stephen R. Rose, Successo/r Trustee Zip Code; 92661 Owner Address: 2`f 2(J/' Ityy(eD /L✓I /� ���J��C%/� _C/l %�� Ll Street ��"y���cityZip CP 2 -el Phone: 7�y�L��� lA/ Phone: lo Z(l- 3 ©tf2 Owner's Authorized Agent: Joe Kaplan, Coldwell Banker Realty Agent Address: 388 S Lake Ave, Pasadena, CA 91101 Work Phone: 626 5840050 Escrow Name and Address: West Coast Escrow, Escrow No. 4520421-02098 - SC Escrow Address: 388 South Lake Avenue, Pasadena 91101 Escrow Phone: (626) 449-0337 Email Report to: TRGWCEPasadenJaLake@trgc.com For Inspection Call (Name)QU5 /i✓ -1 CG/ hl Phone: �� yyd CONSENT TO INSPECT '(FORM 'MUST 'BE SIGNED AND 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 violatio Owner/Agent's signature to authorize inspection Date ZO Z 1 OR Owner/Agent's signature to decline inspection Date Account to CITY OF Who to call fo �inspect(on7 /` Name: J 1! h_'t r� �G G� (Z l Direct Phone: "l i e% or Extension #