HomeMy WebLinkAboutR2023-0422 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 ) Newport Beach, CA 92658-8915
_B,gay (L2023 ^ OLi 2-L— www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
RECEIVED BY
COMMUNITY
DEVELOPMENT
MAY 10 P 1
Application Fee: $202.00 Notice,
(For all Residential Buildings) Application with insufficient fee payment
Reinspection Fee $134.00 or incomplete will be returned
Please type or Print and Complete all information
# of Units: [:A Address: 4 Secret Cove City: Newport Beach Sate: CA] Zip: 92657
Property Owner: Cielo Heavenly Properties LLC a Nevada Limited Liability Company Zip Code: 0
Owner Address: City:
State: Zip Code: Home Phone:
Owner's Authorized Agent: Jahn Cain Work Phone:
Agent Address: 1200 Newport Center Drive Suite 100 1 City: New ort Beach
State: CA Zip Code: 92660 Agent Email Address:
Escrow Company: Granite Escrow R Settlement Services Escrow #: 04 47886JJD
Escrow Address: 450 Newport Center Drive, Suite 600 1 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: 949 720-0110
Email Report to: jdannelfey@graniteescrowcom
For Inspection call (Name): Direct Phone:
CONSENTTO INSPECT (FORM MUST BE SIGNED AND 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/Agent's signature to authorize inspection:
Owner/Agent's signature to decline
Date:
Date: 5/8/23
Account # 01050504-521040.................. Make checks payable to CITY OF NEWPORT BEACH
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