HomeMy WebLinkAboutR2022-0314 - Permits (2)DocuSign Envelope ID: 479B5DFB-A659-474D-9E76-110BD5A47AD6 „,�.eCEIVIFD 's
'i "'y 1— COMMUNITY
",,Form City of Newport Beach
DEVELOPMENT
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION JUL ® 12022
100 Civic Center Drive I P.O. Box 1768 ( Newport Beach, CA92658-8915
RBR#'� www.newportbeachca.gov 1 (949) 644-3200
NTYOF
Application for Report of Residential Building Recordp pc'I
Application Fee: - $198.00 Notice:
(For AIIResidential Buildings) Applications with insufficient fee payment
Reinspection Fee $ 231.00 or incomplete will be returned
Please type or print and complete all information
#ofUnits: Address: 2930 Alta Vista Drive City: Newport Beach State: CA...�Zip: 92660
Property owner: Jeremy and Emily Krout Zip code: 92660
— I
Owner Address: 2930 Alta Vista Drive city: Newport Beach
State: CA Zip Code: 92660 Home Phone: 949-751-8993
Owner's Authorized Agent: I Sara Taylor / Compass work Phone: 714-296-2622
Agent Address: 520 Newport Center Drive, Suite 330 City: Newport Beach
State: CA Zip Code: 92660 Agent Email Address: sara.taylor@compass.com
Escrow Company: Corner Escrow, Inc Escrow #: 07-10073-DS
Escrow Address: 1 31706 Coast Hwy, Suite 302
State: FcA Zip Code: 92651
Emai I Report to: I donnas@cornerescrow.com
For Inspection call (Name):
City: Laguna Beach
_I
Escrow Phone: 949-313-7333
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 [will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection: INSPECT[ 9at!e
DECLINED
OR
DocuSrgned by:
Owner/Agent's signature to decline inspection: R� Date: 06/30/2022
CF3AWffiA E422...
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Buildin DwN.i \Forms\RN 7-1-21