HomeMy WebLinkAboutR2022-0199 - Permit ApplicationCity of Newport BeachcEtvEas ey
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION i1rVFLOPMENT
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-891 1 zoiz
www.newportbeachca.gov 1 (949) 644-3200 NN
RBR# g C10-yov
Application for Report of Residential Building Recor,;s c�
€iRT Se
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:22 Sea Island Drive City: Newport Beach State: CA Zip: 92660
Property Owner: Elizabeth C. Fontao-Calana
Owner Address: 36 Island Ave., #55 City: Miami Beach
State: FL Zip Code: 33139 Home Phone:
Owner's Authorized Agent: Erica Thomas Work Phone:
Agent Address: 1200 Newport Center Drive, Suite 100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 463-7013 Agent Email Address:
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: pkennedy@marinersescrow.com
For Inspection Call (Name):
Escrow # 62657-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 inspe$NSPECCION Date:
DECLINWD
Owner or Agent's signature to decline inspection s /� +71�w 2-u Date:��—
Account # 2900-5005.................Make checks payable to CITY OF NEWPORT BEACH