HomeMy WebLinkAboutR2023-0991 - Permit ApplicationPrint Form City of Newport Beach
RECEIVED BY
COMMUNITY DEVELOPMENT DEPARTMENT COMMUNm
BUILDING DIVISION DEVELOPMENT
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✓e3 01 RBR# - / www.newportbeachca.gov 1 (949) 644-3200
CITY OF
Application for Report of Residential Building Record PORT BEACH
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
# of units: I l Address: 1 415 Avocado Avenue
City: Newport Beach State: CA .:Zip: 92625 „ 1
Property Owner:j CA Avocado 401415, LLC Zip Code: 85018
Owner Address: 1 5060 N 40th St, Ste 250 City: Phoenix
State: _AZ — Zip Code. 85018 Home Phone: (602)230-3506
Owner's Authorized Agent: I First American Title Company Work Phone: (714) 250-3000
Agent Address: 14 First American Way
State: Cq Zip Code: 92707
City: I Santa Ana
Agent Email Address: I teamnancy@firstam.com
Escrow company: I First American Title Company Escrow #: I OSA-7049148
Escrow Address: 14 First American Way
State: ECT Zip Code: 92707
Email Report to: LteamnancMrstam.com
For Inspection call (Name): I Nancy Perez
City: Santa Ana
Escrow Phone: 1 (714) 250-3000
Direct Phone: I (714) 250-4004
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 correctsaid violations.
Owner/Agent's signature to authorize inspection:
Date:
OR
Owner/Agent's signature to decline Date: 11 /4/2023
lfficha'el Pac co, Authorized Representative
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Building Division\Forms\RBR615-22