HomeMy WebLinkAboutR2021-0803 - Permit ApplicationDocuS .Envelope ID: FA15D928-C540-41A7-A629-87BOC4D14533
Print Form City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
[!) n /I /I BUILDING DIVISION
lll 0 Civic Center Drive I P.O. Box 1768 � Newport Beach, CA 92658-8915
RBR# IOVV1 `]4l)www.newportbeachca.gov (949) 644-3200
Application for Report of Residential Building Records
Application with insufficient fee payment
More than 2 units - $192.00 + 11.00 per unit over 2 or incomplete will be returned
Reinspection Fee $88.00
Please type or print and complete all information
# of Units: Address: 741 Avocado Avenue Unit 101 City: Newport Beach State: CA Zip: 92625
Property Owner: Pamela P. Turner
Owner Address:
State: CA Zip Code:
City:
Home Phone:
Zip Code:
Owner's Authorized Agent: Anne Stiefel Work Phone: (949) 717-6000
Agent Address: 450 Newport Center Dr. Ste. 100 City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address: Astiefel(o)VillaRealEstate.com
Escrow Company: Key Escrow. Inc. Escrow # 005983 -BR
Escrow Address: 450 Newport Center Drive 230 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: (949) 698-1960
Email Report To: brandi@keyescrow.com
for Inspection Call (Name):
Direct
CONSENT TO INSPECT (FORM MUST BE SIGNED $ DATED BELOW)
I aulnorize Inspections and re -inspections of the property listed above.
violations are discovered I will be responsible to correct said violations.
Owner/ Agent's signature to authorize inspection: Date:
Owner/ Agents signature to decline inspection: Quxe, Sfil.fiL Date:
�emre.ws,n.ex..
11/22/2021
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH
or