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HomeMy WebLinkAboutR2020-0310 - Permit Application.-....w.,�y�..uvmvyc ,v, wvaewv-l.wli-4uUD-tlG61'-CUHtt9 /`J I-1 rU 6'MCity of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION n 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 RBR# 1-ZO?X- 0 1'0 www.newportbeachca,gov 1 (949) 644-3200 Application for Report of Residential Building Rernr•ric Application Fee: - $191.00 Notice: (For AIIResidential Buildings) Applications with insufficient fee payment Reinspection Fee $129.00 or Incomplete will be returned Please type or print and complete all information I # of Units: Address: 1 612 Hi 1 vanar JI Cit New ort Beach State: CA Zi 92660-4028 City: p. _.. I p—,, PropertyOwner•IPopeye No 1 LLC -4028 Zip Code: 92660 1 Owner Address: 612 Hilvanar City: Newport Beach State: CA Zip Code: 92660-40281 Home Phone 626-864-4060 Owner's Authorized Agent: Ben Lefrancoi s Work Phone: 4-7- 938 Agent Address: 19440 Goldenwest Street City: Huntington Beach State: CA Zip Code: 92648 1W lull[e groat I.cum Agent Email Address: Escrow Company: Central Escrow Group, Inc Escrow#; CEG904510-HJ Escrow Address: 2134 Main Street #185 City: Huntington Beach i State: CA Zip Code: 92648 Escrow Phone: 714-698-9982X104 Email Report to: heidi.james@centralescrowgroup.com For Inspection call (Name) I Heidi James I Direct Phone: 714-698-9982X104 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 DocuSlSned by: Owner/Agent's signatureto decline inspection: I Date: 3/25/2020 l 2:49 F DDB F98AE050E484... —w W r l • ^ v�vJvOvl-�'+w`U ,,,,,,,,,,,,,,,,,macre cnecrcs payable to: CITY OF NEWPORT BEACH Bull dIng DlvIslon\Forms\RBR 9.18. 18