HomeMy WebLinkAboutR2020-0817 - Permit ApplicationPrint Form City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT '�*MMtUtVlgt ?
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA 92649912 3 ,RptV
RBR# Zb ' ��� www.newportbeachca.gov J (949) 644-3200
Application Fee: - $194.00
(For AIIResidential Buildings)
Reinspection Fee $129.00
#of Units: l i Address:
�nDEVELOPMENT
for Report of Residential Building Rec&is
Notice:
Applications with insufficient fee payment
or incomplete will be returned
Please type or print and complete all information
2018 Vista Cajon
PropertyOwner. Eric Becktell
City: Newport Beach State: CA .Zip: 92660
Owner Address: 1 2018 Vista Cajon CityNewport Beach
State: CA Zip Code: 92660
Zip code: 92660
Home Phone:1 9492937092
Owner's Authorized Agent: I Sheri Rathor Work Phone: 1 9493062266
Agent Address: 1 27401 Los Altos, Suite 100 city- F Mission Viejo
State: CA Zip Code: 9291 Agent Email Address: I sheriraflior@gmafl.com
Escrow Company: I Escrow Lenders
Escrow Address: I 31601 Avenida Los Cerritos, Suite 200
State: FCA Zip Code: 92660
Email Report to: I valerlev Q@escrowleaders.cpm
Escrow #: I 20 -5041 -KR
City: San Juan Capistrano
Escrow Phone: I 9493737018
For Inspection call (Name): Eric Becktell Direct Phone: 9492937092
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/Agent's signature to authorize inspection:
Owner/Agent's signature to decline inspection:
B ldmg DNW.o \ or.s\RBR_7-30.20
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Date:
Date: 1 09/23/2020
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH