HomeMy WebLinkAboutR2021-0212 - Permit ApplicationCity of Newport Beach *,CSI1ED s).
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION 0EVEL.:'PSE q
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 9265 921
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Application for Report of Residential Building RQf,ords . cx,
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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:325 1/2 Marguerite Avenue City: Newport Beach ( Corona Del Mar Area ) State: CA
Zip: 92625
Property Owner: Steven H. Nelson and Susan L. Nelson
Owner Address: - City:
State: -Zip Code:- Home
Owner's Authorized Agent: Carol Lee/ Robyn Ziepeer Work Phone:
Agent Address: 1600 Newport Center Drive Suite 250, City: Newport Beach State: CA
Mobil Phone: - Agent Email Address: carol.lee(r)compass.com
Escrow Company: Mariners Escrow Escrow # 60335 -DJ
Escrow Address: 270 Newport Center Drive, Suite 200 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: 949-640-6040
Email Report To: djohnson@marinersescrow.com
For Inspection Call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Zip Code: 92660
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 Date:
OR
Owner or Agent's signature to decline inspection 1 4, t Date: `ems
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH