HomeMy WebLinkAboutR2020-0845 - Permit ApplicationPtint:Ealmsy City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
r� 100 Civic Center Drive P.O. Box 1768 Newport Beach, CA 92658-8915
RBR#KIM-y1 -ONS www.newportbeachca.gov (949) 644-3200
Application for Report of Residential Building Records
Application Fee: - $194.00 Notice:
(For All Residential Buildings) Applications withinsufficient fee payment
Reinspection Fee $129 00 or incomplete will be returned
Please type or print and complete all information
#of Units Address: 1201 Dolphin Terrace City: Newport Beach i State: �CA Zip: 92 62 5
Property Ownerf DLI Properties, LLC ZipCode:F
Owner Address: 14320 Ventura B1vd.,Suite 527 City:ls erman Oaks
SCA Zip Code: j91423 Home Phone. j 0310) 294-8022
State:
I 11_ I_mv
Owner's Authorized Agent: I Amy A4r4�,.ar� my�
Agent Address: 150 El Camino Dr., Suite 150
I
Work Phone: 1 (310) 819-3250
City:lBeverly Hills
State: CA Zip Code. 90212 Agent Email Address: I amy@thealtmanbrothers.com
Escrow Company: IA and A Escrow Services, Inc.
Escrow Address: 1 415 N. Crescent Dr, Suite 320
State CA Zip Code: FE70
Escrow#:l 104889 -AA
City: F everly Hills
Escrow Phone: 1 (310)550-6055''
Email Report to:, antonia@aaescrow.com
For Inspection call (Name):
Amy T..::mi@w= Hee Direct Phone: 310) 819-3250
CONSENT TO INSPECT tFORM 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 DU o.LLC
Owner/Agent'e signatureto authorize inspecti*: Date:
OR
Owner/Agent's signature to decline inspection: Date:
Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORT BEACH
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