HomeMy WebLinkAboutR2020-0844 - Permit ApplicationPrint Form
RBR# 2V�V D041
City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 Newport Beach, CA 92658-805
www.newportbeachca.gov (949) 644-3200 o c
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Application for Report of Residential Building Records
Application Fee: - $194.001l "
Notice:
(For All Residential Buildings) Applications with insufficient fee RI(ment
Reinspection Fee $129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: Address: 6 FAIR HARBOR City: NEWPORTCOAST State: CA Zip: 92657
PropertyOwner:l. LEI JIANG, LIANG BIN XIONG
Owner Address: 16FAIRHARBOR
State: CA Zip Code:92657
Owner's Authorized Agent: I CINDY CHIN
Agent Address: 1 25531 COMMERCENTRE DR. #120
State:CA Zip Code: 92630
Escrow Company: I CENTRAL ESCROW GROUP, INC
Escrow Address: 120 CORPORATE PARK STE: 185
State: FCA Zip Code: F92606
Zip Code: F92657
City: I NEWPORT COAST
Home Phone:
Work Phone: 1949-698-0117
City: LAKE FOREST
Agent Email Address: I CINDY@CINDYCHINREALTY.COM
Email Report to: I MING.CI@CENTRALESCROWGROUP.COM
For Inspection call (Name): I MING CI
Escrow #: CEG605388-CM
City: I IRVINE
Escrow Phone:
Direct Phone: 626-636-0097
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:
IO
Owner/Agent's signature to decline inspection:
Account # 01050504-521040 .................Make checks nnvnhlp
Building Division\Forms\RBR_7-30-20
Date:
Date: OR— 21 —2/p
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