HomeMy WebLinkAboutR2020-0807 - Permit Applicationnomm City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
p 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach,
RBR#P02o-QKQ www.newportbeachca.gov 1 (949)644-3200
Application for Report of Residential Building
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# of Units: Address: 315 E. Balboa Blvd. J City: Newport Beach State: CA !Zip: 92661
Property Owner: Tafee Trust Zip Code: 77
Owner Address: City:
State: CA Zip Code Home Phone:
Owner's Authorized Agent: SII Work Phone:
.. -- ---........-- ----------- --_
Agent Address: City:
State: I Zip Code: 177 Agent Email Address:
Escrow Company: Freedom Escrow ',... Escrow #: 054018 -MM
Escrow Address: 1200 Newport Center Dr., Suite 180 City: Newport Beach
State:CA � Zip Code: 92660 Escrow Phone: (949) 644-3939
Email Report to: mm@freedomescrow.com
For Inspection call (Name): N/q -- - -.- -.-- - -- _ Direct Phone
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
l 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/Agent's signature to authorize inspection: Date:
OR
Owner/Agent's signature to decline inspection: ate:—
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Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Bu11dinC0ivislon\Forms\RBR_7-30-20