HomeMy WebLinkAboutR2020-0802 - 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# MN
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 type or print and complete all information
# of Units:1 Address:2433 Francisco Drive City: Newport Beach State: CA Zip: 92660
Property Owner: Slach Family Trust. dated July 9. 2015, and any amendments thereto
Owner Address: - City:
State: Zip Code: - Home Phone:
Owner's Authorized Agent: Krista McIntosh Work Phone:
Agent Address: 450 Newport Center Drive, Suite 100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 296-5094 Agent Email Address: kmcintoshOvillarealestate.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email ReportTo: djohnson@marinersescrow.com
For Inspection Call (Name):
Escrow # 59257 -DJ
City: Newport Beach
Escrow Phone: 949-640-6040
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 Date:
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Owner or Agent's signature to decline inspection ��6i�-- I ate:S
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH
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