HomeMy WebLinkAboutR2023-0530 - Permit ApplicationRECEIVED BY
COMMUNITY
DEVELOPMENI
Print For City of Newport Beach �i t! f2 2023
COMMUNITY DEVELOPMENT DEPARTMENT t
BUILDING DIVISION CITY OF
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8910N!PORTSFACH
P,a 2 202- 3 - 053 -,:) www.newportbeachca.gov 1 (949) 644-3200
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
Please type or print and complete all information
# of Units: Address: 84 Lessay
City: Newport Beach State: CA zip: 92657
Turnbury LLC - Lilly Vahil Zip Code: I
Owner Address: I City:
State: F Zip Code: F Home Phone:
Owner's Authorized Agent: Work Phone:
Agent Address: City:
State: Zip Code: F Agent Email Address: F
Escrow Company: I Freedom Escrow
Escrow #: 1055852-MM
Escrow Address: 1200 Newport Center Dr., Suite 180 city FNewport Beach
State: FcA Zip Code: F 92660 Escrow Phone: (949) 644-3939
Email Report to: mm@freedomescrow.com
For Inspection call (Name): I N/A 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:
Owner/Agent's signature to decline
OR
Date:
Date: 1 06/09/2023
Builtling BiwM.n\F.,.,\RBR 6-15-22
Account # 01050504-521040.................Make checks payable to: CITY OF NEWPORT BEACH