HomeMy WebLinkAboutR2023-0202 - Permit ApplicationRECEIVED By
COMMUNITY
Print Form City of Newport Beach DEVELOPMENT
COMMUNITY DEVELOPMENT DEPARTMENT LA,y O 8 2023
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA92658-16F
RM 92oZ5 ^OZoZ www.newportbeachca.gov 1 (949) 644-3200 NEWPORT BEACH
Application for Report of Residential Building Records
Application Fee: - $202.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $134.00 or incomplete will be returned
# of Units: I ` Address:
Please type or print and complete all information
601 Lido Park D
Damodice Holdings II LLC
D City: Newport Beach State: Zip: 92663
Owner Address: I City:
State: CA Zip Code: F
Owner's Authorized Agent:
Agent Address:
State:
Zip Code:
Escrow company: I Freedom Escrow
City:
Agent Email Address:
Escrow Address: I 1200 Newport Center Dr., Suite 180
State: FCA Zip Code: 92660
Email Report to: mm@freedomescrow.com
For Inspection call (Name): I N/A
Zip Code: �—
Home Phone:
Work Phone:
Escrow #:1055726-MM
City: I Newport Beach
Escrow Phone: I (949) 644-3939
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 I will be responsible to correct said violations.
Owner/Agent's signatu re to authorize inspection: Date:
OR
Owner/Agent's signature to decline 64.411,4 +„/% 13/AGCA.,,,— Date: US.ob-
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
BuTding DmW n\Forms\RSR_6-15-22