HomeMy WebLinkAboutR2022-0173 - Permit ApplicationgeCEf ft 6
City of Newport Beach COMMUNITY
F
COMMUNITY DEVELOPMENT DEPARTMENT OEVELOPMENI
BUILDING DIVISION 2022
100 Civic Center Drive I P.O. Box 1768 Newport Beach, CA 92658-89,
RBR# r9 www.newportbeachca.gov 1 (949) 644-3200
cITYOF
Application for Report of Residential Building
Please type or print and complete all information
# of Units: Address: 2322 Margaret Drive City: Newport Beach State: CA ;Zip: 92663
Property Owner: The Edward Snyder Trust Zip Code:
Owner Address: City:
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State:
------- State: CA Zip Code Home Phone:
Owner's Authorized Agent: Work Phone:
...----- ..--- ----_ _.�
Agent Address: City:
State: Zip Code: Agent Email Address:
Escrow Company: Freedom Escrow Escrow #: 055264 -MM
Escrow Address: 1200 Newport Center Dr., Suite 180 City: Newport Beach
State: r CA Zip Code: 92660 Escrow Phone: (949) 644-3939
Email Report to: mrnTreedomescrow.com
For Inspection call (Name): N/A Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
1 authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning
violations are discovered l will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection: INSPECTION Date:
OR LINED
Owner/Agent's signature to decline inspection: _ f3 /jSr4/,-Date:
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Buildin,Dlvlsion\forms\RBB J-1-21