HomeMy WebLinkAboutR2024-0012 - Permit ApplicationPrint Form City of Newport Beach RECEIVED By
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNITY
BUILDING DIVISION DEVELOPMENT
n 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA99jWe0%)jR?4
RBR#'L�y' 0��2 www.newportbeachca.gov 1 (949) 644-3200
CITY OF
Application for Report of Residential Building RecowdsTBEACH
Application Fee: -$208.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $138.00 or incomplete will be returned
Please type or print and complete all information
#ofUnits: I ' Address: 2015 Yacht Vindex City: Newport Beach State: CA Zip: 92660
Propertyowner: Carol LaFourcade .Robinson Zip Code: F92660
Owner Address: City:
2015 Yacht Vindex Newport Beach
State: CA Zip Code: F92660 Home Phone: 760 835 0922
Owner's Authorized Agent: Work Phone:
Jeanne LaFourcade 714 745 4957
Agent Address: City:
12665 Stanton Avenue Tustin
State: C Zip Code: 9� Agent Email Address:
JeanneLafoucade@gmail.com
Escrow Company:
Escrow Technologies
Escrow Address:
5000 Birch St, Suite 3000-352
State: Ca Zip Code: 92660
Email Report to: Terri@escrowtech.net
For Inspection call (Name):
Escrow #:I N24-00860-TE
City: Newport Beach
Escrow Phone: 1949-945-291 4
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 responsibleto correct said violations.
Owner/Agent's signature to authorize inspection: Date:
OR
Owner/Agent's signature to decline / L+L Date:
Account # 01050SO4-S21040 _ __ _ __. _ _. Mnka r•hor•kc nnvnhlo to • [I OF NFWDART RF4[N
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5000 Birch Street, Suite 3000-352 West Tower • Newport Beach, CA 92660• Tel: (949) 390-5828
January 8, 2024
City of Newport Beach
100 Civic Center Drive
Newport Beach, Ca 92660
Attn: Building department
Property: 2015 Yacht Vindex, Newport Beach
Enclosed is the Check in the amount of $208.00 and Residential Building report signed.
Sincerely
Terri Eden
Escrow Officer
Del
enclosed