HomeMy WebLinkAboutR2020-0518 - Permit ApplicationCity of,N,ewport Beach
COMMUNITY DEDIVISION DEPARTMENTBUI�oMMuNiey
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8%14ELoPMeN`
www.newportbeachca.gov 1 (949) 644-3200 5 9020
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Application for Report of Residential Building Records ciTvoF
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Application Fee: $191.00 Notice: Applications with insXlcient fee
payment
Reinsoection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: -1— Address:224 Via Palermo City: Newport Beach State: CA Zip: 92663
Property Owner: The 2013 Sanita Family Trust
Owner Address: - City:
State: -Zip Code: - Home
Owner's Authorized Agent: Jon Flagg Work Phone: (949) 698-1910
Agent Address: 450 Newport Center Drive, Suite 100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 533-7878 Agent Email Address: JFlaga@VIIlaRealEstate.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 # 58503 -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 Date:
OR
Owner or Agent's signature to decline inspection Date:
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH