HomeMy WebLinkAboutR2020-0297 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR#2www.newportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Records
Application Fee: $184.00 Notice:
(For all Residential Buildings) Application with insufficient fee payment
Reinspection Fee $125.00 or incomplete will be returned
Please type or print and complete all information
# of Units: = Address: I 11 Avignon I City: New ort Beach Sate: CA Zip: 92657
Property Owner: Harvey G. Lehtman, Successor Trustee, of the Sharon Rose Fisher Revocable Zip Code:
Trust UD T dated November 3, 2003
Owner Address: I I City:
State: 0 Zip Code: 0 Home Phone:
Owner's Authorized Agent: I Meital Taub I Work Phone: 949 922-9552
Agent Address:
1900 Glenneyre St.
City: I
la una beach
State: CA
Zip Code: 92651
Agent Email Address: meltal@taubproperties.com
Escrow Company: I Granite Escrow & Settlement Services Escrow #: I 04-42377-JJP
Escrow Address: 1450 Newport Center Drive, Suite 600 1 City: New ort Beach
State: CA Zip Code: 92660 Escrow Phone: 949 720-0110
Email Report to: I jparker@graniteescrow.com
For Inspection call (Name): I Direct Phone:
CONSENT TO 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.
Owner/Agent's signature to authorize inspection: Dater
ocu gne y: _ _ -
OR
Owner/Agent's signature to decline inspectior�eeegnciooFegagg... Date: 3/23/2020
Account # 01050504-521040 .................. Make checks payable to CITY OF NEWPORT BEACH