HomeMy WebLinkAboutR2022-0316 - Permits (2)City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach,
RBR# www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building
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COMMUNITY
DEVELOPMENT
CA92658'89Q ....
Please type or print and complete all information
CITY OF
#ofUnits: Address: 3602MarcusAvenue City: Newport Beach State: CA ; Zip: 92627
Property Owner: MAS Investments, L.P. Zip Code:
Owner Address _ City:'..
State: CA Zip Code: Home Phone:
Owner's Authorized Agent: Work Phone:
Agent Address: City:
State: F Zip Code: F- Agent Email Address:
Escrow Company: Freedom Escrow i Escrow #: 055436-MM Ali
Escrow Address: 1200 Newport Center Dr., Suite 180 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: (949)644-3939 j
Email Report to: mm@freedomescrow.com'.
For Inspection call (Name): N/A 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 Iwill 'beresponsible tocorrect said violations. �+
Owner/Agent's signature to authorize inspection: INSPECTIO Nate:
OR DECLINED
Owner/Agent's signature to decline inspection: �7�9A6E� f Date:
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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