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HomeMy WebLinkAboutR2021-0060 - 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 www.newportbeachca.gov 1 (949) 644-3200 RBR# It ZQZ L ` D&0 Application for Report of Residential Building Records Application Fee: $194.00 Notice: Applications with insufficient fee payment Reinspection Fee $ 129 00 or incomplete will be returned Please jype or print and complete all information # of Units:_1 Address:21 Augusta Lane City: Newport Beach State: CA Zip: 92660 Property Owner: Steve Bruno and Kim Bruno Owner Address: - City: State: Zip Code: - Home Owner's Authorized Agent: Lindsay Bibb Work Phone: Agent Address: 450 Newport Center Drive Suite 100, City: Newport Beach State: CA Zip Code: 92660 Mobil Phone: - Agent Email Address: lindsay(alindsaybibb.com Escrow Company: Mariners Escrow Escrow # 59982 -BF Escrow Address: 270 Newport Center Drive Suite 200 City: Newport Beach State: CA Zip Code: 92660 Escrow Phone: 949-640-6040 Email Report To: bfoxcroft@marinersescrow.com 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 OR Owner or Agent's signature to decline inspection Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH