HomeMy WebLinkAboutR2021-0231 - Permit ApplicationJ67J
t� 7'ritrtPtsrm City of Newport Beach rJuiiauldl7}l
COMMUNITY DEVELOPMENT DEPARTMENT Vi=ht ;,i1;q iti,I.
BUILDING DIVISION �n
26 2 � � �/J7 100 Civic Center Drive I P.O. Box 1768 i Newport Beach, CA92658-89 ,AR 2 6r 2021
G v S www.newportbeachca.gov 1 (949)644-3200
CITY t)j-
Application
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Application for Report of Residential Building Records,,,.
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Application Fee: -.$194.00 "C -PT
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: Address: 1 2032 PORT BRISTO11 L CI11 R City: Newport Beach State: CA Zip: 92660
Property Owner: 2032 PORT BRISTOL L 1. LC Zip Code: 92660
Owner Address: 2032 PORT BRISTOL CIR City: NEWPORT BEACH
State: CA _ Zip Code:92660 Home Phone
Owner's Authorized Agent: FEI LI Work Phone: 949-353-9999
Agent Address: 4010 Barranca Pkwy #100 City: IRVINE
State: _ CA Zip Code: 92604 Agent Email Address: fei@feiliestates.com
Escrow Company: CENTRAL ESCROW GROUP INC. Escrow #: CEG606666-CM
Escrow Address: 20 CORPORATE PARK, STE 185 City: IRVINE
State. CA Zip Code: F92606 Escrow Phone: 949-333-8788
EmailReportto:I MING.CI@CENTRALESCROWGROUP.COM
For Inspection call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
Iauthorize inspectionsand 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/Agents signature to authorize inspection: Date:
O
Owner/Agent's signature to decline inspection: �: ` '\� Date: 13 --1J Z.(
Account It 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Bu,ldm,Dw.5.0n\Forms\RBR 7-30-20