HomeMy WebLinkAboutR2021-0797 - Permit ApplicationV_ 202 k 09-q -j-
City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
7 rI www.newportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Records
Application Fee: $195.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 131.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_ Address:1556 August Lane City: Newport Beach State: CA Zip: 92660
Property Owner: The Tyler Andrew Case and Jacquelyn Taylor Case Living Trust dated 11/23/2020
Owner Address: 1556 August Lane City: Newport Beach
State: CA Zip Code: 92660 Home
Owner's Authorized Agent: Carter Kaufman Work Phone:
Agent Address: 520 Newport Center Dr. Ste 330, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 294-6411 Agent Email Address: carter(a)carterkaufman.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: swelker@marinersescrow.com
Escrow # 61898 -SW
City: Newport Beach
Escrow Phone: 949-640-6040
For Inspection Call (Name): n/a Direct Phone:
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 or Agent's signature to authorize inspection Date:
OR
Owner or Agent's signature to decline inspection Date:
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH