HomeMy WebLinkAboutR2022-0196 - Permit ApplicationPnnt Form City of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION APR 13 2022
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBR# V Xi www.newportbeachca.gov 1 (949) 644-3200
CITY OF
Application for Report of Residential Building Recorp c111
Application Fee: - $198.00 Notice:
(For All Res (dential Buildings) Applications with insufficient fee payment
Reinspectlon Fee $131.00 or Incomplete will be returned
Please type or print and complete all information
#of Units Address: I 20 Rue Villars City: Newport Beach State: Zip: 92660
Propertyowner. H. George Brennan Zip Code: F92660
Owner Address: 20 Rue Villars City: Newport Beach
State: CA^ Zip Code: 92660 Home Phone: 1 (949) 335-1284 -
Owner's Authorized Agent: Ron Wade Broker Work Phone: 1 ( 949) 929-4695
Agent Address: 6 Saint Pierre City: Tra4uco Canyon
State: CA Zip Code: FP2679 Agent Email Address: ronwade.re@gmail.com
Escrow Company: Advantage One Escrow Escrow #: 271255-MV
Escrow Address: 19671 Beach Blvd #103 City: Huntington Beach
State: MCA Zip Code: F92647 Escrow Phone (714) 962-0999
Email Report to: margo@advantageoneescrow.com
For Inspection call (Name): ; Direct. Phone: I
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/Agent's signature to authorize inspection: Date:
RECLINED
Owner/Agent's signature to decline inspection: 2.4mijDate:
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