HomeMy WebLinkAboutR2020-0477 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-891&��otilvea ay
www.newportbeachca.gov 1 (949) 644-3200 OOMMUNI'fv
[)EVE UPMENT
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Application for Report of Residential Building Record's
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Application Fee: $191.00 Notice: Applications with insufficient fe4b,
payment "PWPORT ?3
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: -1— Address:1627 Port Barmouth Place City: Newport Beach State: CA Zip: 92660
Property Owner: Kevin P. Smith and Melissa L. Smith
Owner Address: - City:
State: -Zip Code: - Home
Owner's Authorized Agent: Kevin Smith Work Phone:
Agent Address: 341 Bayside Drive. City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: - Agent Email Address: Kevin.smith@compass.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email ReportTo: djohnson@marinersescrow.com
For Inspection Call (Name):
Escrow # 58472 -DJ
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
Account #
2900-5005 ................. Make chegks payable to CITY OF NEWPORT BEACH