HomeMy WebLinkAboutR2022-0074 - Permit ApplicationCity of Newport Beach *Qovl D /J),
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION DEVELOPMENT
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200 "6 2022
RBR# " - " �D �� CITY OF
Application for Report of Residential Building Re%rds c�
PORT BEP
Application Fee: $198.00 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:562 Glorieta City: Newport Beach State: CA Zip: 92660
Property Owner: Michael Dylan Zeller and Stacey Lynn Borrego
Owner Address: 562 Glorieta City: Newport Beach, CA 92660
Home Phone:213-253-8391
Owner's Authorized Agent: Katherine McCandless Work Phone:
Agent Address: 1099 Stewart St Suite 600 City: Seattle State: CA Zip Code: 98101
Mobil Phone: (949) 682-6144 Agent Email Address: katherine.mccandless@redfin.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: pkennedyflmarinersescrow.com
For Inspection Call (Name):
Escrow # 62333 -PK
City: Newport Beach
Escrow Phone: 949-640-6040
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
OR
Owner or Agent's signature to decline inspe ions Date: .a
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH