HomeMy WebLinkAboutR2020-0351 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Boz 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
RBRIT U_ "' V5S 1
Application for Report of Residential Building Records
Application Fee: $191.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_ Address:210 Orange Street City: Newport Beach State: CA Zip: 92663
Property Owner: Sailhouse Orange, LLC
Owner Address: - City:
State: Zip Code: - Home
Owner's Authorized Agent: Nicolai Glazer Work Phone:
Agent Address: 1200 Newport Center Drive Suite 100 City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 306-8339 Agent Email Address: nicolaiCd)nicolaiglazer.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: bfoxcroft@marinersescrow.com
For Inspection Call (Name):
Escrow # 58185 -BF
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
Owner or Agent's signature to decline inspection / / 1 V Date: 11 ! `O�7,0
Account # 2900-5005 ....... vMoke chocks -payable Yo CITY OF NEWPORT BEACH