HomeMy WebLinkAboutR2020-0292 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT REEF
BUILDING DIVISION coy14� 1 Fp
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 F4oA�tirr
www.newportbeachca.gov 1 (949) 644-3200 r IFN
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RBR# O Zq �'0191
Application for Report of Residential Building Recoils t\'ryoa
Application Fee: $191.00 Notice: Applications with insdita Wt fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_1 Address:419 Iris Avenue City: Newport Beach ( Corona Del Mar Area ) State: CA Zip: 92625
Property Owner: Ocean Surf Trust dated March 4th, 2012
Owner Address: - City:
State: -Zip Code:- Home
Owner's Authorized Agent: Jesse Barraza Work Phone:
Agent Address: 1400 Newport Center Drive, Suite 100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: - Agent Email Address: ibarraza@surterreproperties.com
Escrow Company: Mariners Escrow Escrow # 57990 -RB
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: rbuenrostro@marinersescrow.com
For Inspection Call (Name):
City: Newport Beach
Escrow Phone: 949-640-6040
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 or Agent's signature to authorize inspection
O
Owner or Agent's signature to decline inspection Date:
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH