HomeMy WebLinkAboutR2020-0280 - Permit ApplicationP�C,�IVEO @y
COMMUNITY
;~ ur City of Newport Beach DEVCLOFMENT
COMMUNITY DEVELOPMENT DEPARTMENT MAR 1 1 202®
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
f a CITY OF
RBR# (L.._ /�(,) 0 L �� www.newportbeachca.gov � (.949)644-3200
mppiicauon Tor tteport of Residential Building Recorii?ORT 51" -
Application Fee, $191.o0. .
Notice:
(For .All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $129.00 or incomplete will be returned
Please type or print and complete all Information
It of Units: Addressj 1905 YACHT CAMILLA
City;: Newport Beach State: A Zip: ;9266it
Property Owner:,. MATA RAYBURN TRUST
Zip Code:
F 92680:
Owner Address:
1905 YACHT CAMILLA
- City: F NEWPORTBEACH
Stater GA Zip Code:
'.,
.,.
32$6(1
Home Phone: F
Owner's Authorized Agent: PAULA RAYBURN
Work Phone: ( 949-463-8974
Agent Address:
17�-
3857 BIRCH ST, #625
City: NEWPORT REACH
State:. CA._ Zip Code: F 92560 Agent Email Address �AULA.RAYBURN@PAVPRO.COM
Escrow Company: LIGHTHOUSE ESCROW INC
Escrow #tF 19749 -AC
Escrow Address: 2355 MAIN ST., SUITE 130
-m
City: I I� ....
-..
State:
CA
�� Zip Code:
92614
Escrow Phone
800-757-1550
Email Report to:
ANGELA@LIGHTHOUSEESCROW.COM
For Inspection call (Name)::
Direct
Phone:
CONSENT TO INSPECT FQRM MUST BE SIGNED & OA -TED "LOW1:
I autkorize Inspections and re -inspections of the property listed above. Iunderstand that if Building or Zoning.
violations are discovered I will be responsibleto correct said violations.
Owner/Agents signature to authorize inspection:
Owner/Agent's. signature to decline inspection:
8u1lding Division\Forms\R0Re9-18-18
Date:.
Account it 01050504-521040 ..,.........Make checks payable to: CITY OF NEWPORT BEACH