HomeMy WebLinkAboutR2023-0250 - Permit ApplicationIRECEIMly
Print Form City of Newport Beach coA
COMMUNITY DEVELOPMENT DEPARTMENT DEMOPMETR
BUILDING DIVISION
100 Civic Center Drive i P.O. Box 1768 1 Newport Beach, CA92658-8915MAR 3 0 2023
stet fL2-02-3 ' o 2-5 0 www.newportbeachca.gov 1 (949) 644-3200
clry OF
ArAnlirntinn for Rt-nort of Residential Building Records NEWPORT BEACH
Application Fee: - $202.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $134.00 or incomplete will be returned
Please type or print and complete all information
# of Units: Address: 312 Anade Ave City: Newport Beach _ State: ICA IZip:
92661,
Property Owner: Tobin George, Successor Trustee of The Barbara Snow Revocable Trust
City: Gardenerville
Home Phone: (949) 233-1065
owner Address: 11380 Falstaff Ln
State: % NV Zip Code: 89410
Zip Code: F89410
Owner's Authorized Agent: Nancy Perez', Work Phone: 1 (714 ) 250-4004
Agent Address: 4 First American Way City: Santa Ana
State: FcA Zip code: F92707 Agent Email address: teamnancy@firstam.com
Escrow company: First American Title Company Escrow #: OSA-6969749
Santa Ana
Escrow Phone: (714) 250-3000
Escrow Address: 14 First American Way
State: CA Zip Code: F92707
Email Reportto: teamnancy@frstam.com
City:
For Inspection call (Name): Nancy Perez Direct Phone: 1 (714) 250-4004
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 I will be responsible to correct said violations.
Owner/Agent's signatureto authorize inspection:
Owner/Agent's signature to decline
OR
Date:
Date: 3/28/2023
Building
_Ml ion\FormA\1BR_615-22
Account # 01050504-521040 .................maKe cnecKs payame 1u. a.ua I V,-.—
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