HomeMy WebLinkAboutR2021-0446 - 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
(p P� www,newportbeachca.gov (949)644-3200
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Application for Report of Residential Building Records
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(For All Residential Buildings)
Reinspection Fee $125.00
Application with insufficient fee payment '..
or incomplete will be returned '..
Please type or print and complete all information
Number of units: Street Address: 9 Montecito Dr
Property Owner: Cindy S. Greenwald ! Zip Code. 92625 ,
Owner Address:
Street City
Home Phone:Work Phone:
q
Owner's Authorized Agent: HILLARY CASTON, BERKSHIRE HATHAWAY HOMESERVICES
Agent Address: 2 RITZ CARLTON SUITE #201 , Dana Point, CA 92629
Work Phone: 949-922-8490
Escrow Name and Address: West Coast Escrow, Escrow No. 4530621-05957 - LS
Escrow Address: 840 Newport Center Drive, Suite 150 , Newport Beach 92660 Escrow Phone: (949) 759-7072
Email Report to: LAURA.STEINER@WESTCOASTESCROW.COM
For Inspection Call (Name):DECLINE INSPECTION
CONSENT TO INSPECT (FORM MUST BE SIGNED AND 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
Owner/Agent's signature to decline
Date
Account #01050504-521040 .... ... ....Make checks payable to CITY OF NEWPORT BEACH
Who to call for inspection?
Name: Direct Phone: