HomeMy WebLinkAboutR2023-0634 - Permit ApplicationS� amwcWr�-T
RECEIVED By
COMMUNITY
Clt of Newport Beach DEVELOPMENT
Y
COMMUNITY DEVELOPMENT DEPARTMENT JUL 18 2023
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 CITY OF
www.newportbeachca.gov 1 (949) 644-3200 NEWPORT13EACH
RBR# 2� OZ 3 � O(o Zi t-f
Application for Report of Residential Building Records
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: = Address: I 8 Amador I City: I NewDort Beach I Sate: CA Zip: 92657
Property Owner: I Mahmoud Eslami TTE Sansev Trust and Nar es Eslami TTE Sansev Trust Zip Code:
Owner Address: I City:
State: 0 Zip Code: Home Phone:
Owner's Authorized Agent: I Marcus' Kiwi' Gaulter Work Phone:
Agent Address: 1 840 Newport Center Dr., Ste. 100 1 City: New ort Beach
State: F—C—A-7 Zip Code: 92660 Agent Email Address:
Escrow Company: I Granite Escrow 8 Settlement Services Escrow #: 04-48048-JJP
Escrow Address: 1 450 Newport Center Drive, Suite 600 City: I New ort Beach
State: CA Zip Code: 92660 Escrow Phone: EE9720-0110���
Email Report to: I iparker raniteescrow.com
For Inspection call (Name): I 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.
Date: