HomeMy WebLinkAboutR2022-0283 - Permits��cEIVED AR),
COMMUNITY
City of Newport Beach DEVCI-OPMENT
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION JUN 0 9 2022
ccg� 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
RBRZ�ZU� www.newportbeachca.gov 1 (949) 644-3200 TY OF
Application for Report of Residential Building Records `'�rroRt 50-1w
Application Fee: - $198.00 Notice:
(For All Residential Buildings) 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: 105 Jasmine Creek ;City: Newport Beach State: CA •IZip: 92626....
Propertyowner:BonnieV.Schultz ) Zip Code: 92626
Owner Address: 105 Jasmine Creek city: Newport Beach
State:.CA Zip Code 92626 Home Phone: 949-759-7072
Owner's Authorized Agent: Suzanne Wyrick Work Phone: 49-466-3161 -..
Agent Address_ _ 3l✓'UriP, rlVe City, Newport Beach -
State: CA Zip Code: 92625 Agent Email Address:
suz9921Qgmail.com
Escrow Company: West Coast Escmw _..._._� Escrow#: 22-04347
Escrow Address: 840 Newport Center or #150 City: Newport Beach
State: I Cr n Zip Code: 92669. --- Escrow Phone: 949-759a072
Email Report to: laura.steiner@westcoastescmw.com
For Inspection call (Name): NA 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 l will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection:
Owner/Agent's signature to decline inspection:
UK
4� Date: -
Bul1ding_Divi5i0n\Form5\RBR 7-1-21
Account # 01050504-521040 .................Make checks payable to: CITYOF NEWPORT BEACH