HomeMy WebLinkAboutR2020-0783 - 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#
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
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# of Units:1 Address: 91 Ocean Vista City: Newport Beach State: CA Zip: 92660 6A
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Property Owner: The Smith Family Trust established January 13, 1989
Owner Address: - City:
State: -Zip Code:- Home Phone:
Owner's Authorized Agent: Denine Kerns Work Phone: (949) 689-7078
Agent Address: 12 Corporate Plaza #250, City: Newport Beach State: CA
Mobil Phone: - Agent Email Address: Denine.Kerns@elliman.com
Escrow Company: Mariners Escrow Escrow # 59182 -RB
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Zip Code: 92660
Escrow Address: 270 Newport Center Drive, Suite 200 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: 949-640-6040
Email Report To: rbuenrostro@marinersescrow.com
For Inspection Call (Name): Denine Kerns Direct Phone: _ 949-689-7078 _
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 violations.
Owner or Agent's signature to authorize inspection Date: q— Sr -2 O?0
OR
Owner or Agent's signature to decline inspection
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH