HomeMy WebLinkAboutR2021-0186 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
V2'071-61
00 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
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RBR# �2I 61(sL9 - www.newportbeachea.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Application Fee: - $194.00 Notice:
(For AIIResidential Buildings) Applications with insufficient fee payment
Reinspection Fee $129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: F Address: 37 OCEAN VISTA City: Newport Beach ' State. CA Zip:92660
PropertyOwner: KEITH L. HOFFMANN and BARBARA J. HOFFMANN
Zip Code:
Owner Address:11 37 OCEAN VISTA City: NEWPORT BEACH
�— __ _-__- 602-717-4140 __
State: CA Zip Code: 92660 i Home Phone:
Owner's Authorized Agent: I KYLE HOFFMANN
Agent Address: 1 2820 CAMINO DEL RIO SOUTH, #314
Work Phone: 949-371-4098
City: I SAN DIEGO
CA
State: Zip Code: 92108
Agent Email Address: khoff@fixere.com
Email Report to: f fabi@advancedescrows.com
For Inspection call (Name): KYLE HOFFMANN j Direct Phone: 949-371-4098
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
-a
I authorize inspections and re -inspections of the property listed above. I understand that if Building crrtoning
violations are discovered I will be responsible to correctsaid violations.
Owner/Agent's signature to authorize inspection:
Date:
R
F
Owner/Agent's signature to decline inspection: Date:
Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORT BEACH
Buildin�Division\Forms\RBR 7-30.20