HomeMy WebLinkAboutR2023-0632 - Permit ApplicationDocuSign Envelope ID: A4FD1A13-116F-4F76-9A5A-7F983DA99195
Print Form City of Newport Beach CO RECEIVED B1Yr
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION LL����
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA9�M3-�AaO23
RBR#R2O23 _ www.newportbeachca.gov 1 (949) 644-3200 CITY OF
IN
Application for Report of Residential Building RecAVpTBEACH
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: T Address: FH7 Dover Dr
Property Owner: I TFP 1, LLC
Owner Address: 112520 High Bluff or #285
State: CA Zip Code: F92330
City: Newport Beach State: CA Zip: 92660
City: I San Diego
Owner's Authorized Agent: Ever Eternity
Agent Address: 17520 High Bluff Or #285 City:
State:F CA Zip Code: 92660 Agent Email Address:
Escrow Company: I Oakwood Escrow
Escrow Address:) 2690 via De La Valle, D260
State: CA Zip Code: F92014
Email Report to: I TeamRandDouglas@gmail.com
For Inspection call (Name): I
Home Phone:
Zip Code: 92660
760-847-3745
Work Phone: I 858-688-4113
San Diego
TeamRandoouglas@gmail.com
Escrow #: I 6250-CS
City: I Del Mar
Escrow Phone:1 619-430-4592
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 signature to authorize inspection:
Date:
OR
E6D E47FS 1232459...
Owner/Agent's signature to decline .Uy(Date:
Docusigned By: Ever Eternity
Account It 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
BWding DivlsionVo ms\RRR6-15-22