HomeMy WebLinkAboutR2022-0309 - Permits (2)10rint Farm City of Newport Beach OcEI ft �9F,
COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVEtoFMENt
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA9269-6452022
RBR#�J� www.newportbeachca.gov 1 (949) 644-3200
CITY (9F
Application for Report of Residential Building Refflyds
SORT BE
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: 5 San Sebastian
Propertyowner:I Marsha Stein
Owner Address: 15 San Sebastian
State: CA Zip Code: FE660
City: Newport Beach State: CA Zip: 92660
Zip Code: F92660
City: I Newport Beach
Joseph Maghami - 949/813-1619
Home Phone: Mina Maghami - 949/874-4020
Owner's Authorized Agent: Mina Maghami Work Phone: Joseph ag ami - 9 1�
Mina Maghami - 949/874-4020
Agent Address: Berkshire Hathaway HomeService City: Newport Beach
1400 Newport Center Drive #200_
State: CA Zip Code: I 92660 Joseph Maghami <kjmaghami@gmail.com>
Agent Email Address: Mina Maghami <minamaghami@gmaii.com>
Escrow Company: ( Corner Escrow Inc.
Escrow Address: 18600 MacArthur Blvd. Suite 350
State: ca Zip Code: 92612
Escrow #: I 08-VK
City: Prvine
Escrow Phone: 1 949-800-8908
Email Report to:I vesna.kopac@cornerescrow.com; kjmaghami@gmaiLcom; minamaghami@gmaiLcom
rr, ocon, oe+
For Inspection call (Name): osep Maghami: 9 -1 9 Direct Phone: oseph Maghami: 949/813-1619
Mina Maghami: 949/874-4020
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
l 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: 1 s J4<1 Dater G17—q(,2o2Z
Owner/Agent's signature to decline inspection:
OR
Date:
Building Division\Farms\RBR_7.1.21
Account # 01050504-521040 .................Make checks payable to: CITY OFNEWPORTBEACH