HomeMy WebLinkAboutR2020-0557 - Permit ApplicationDocuSign Envelope ID: 396CB201-865E-4EE6-B1A3-E423CB48A18C RECEII,�O
�YHiCity of Newport Beach
COMMUNITY DEVELOPMENT, DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA ,6
RBR# '"' www.newportbeachca.gov (949) 644-3200 4OpM
T rea
Application for Report of Residential Building Recor&PORT Be:
Application Fee: -.$191.00 Notice:6
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $129.00 or incomplete willbe returned
Please type or print and complete all information
#of Units: �,, Address: g27 Spring Tide Dr City: Newport. Beach..) State: CA_.IZip: 92660_,
Property Owner:St. Hilaire Family Trust (Chris & Brenda St. Hilaire, Trustees)'
Zip Code:
Owner Address: 927 spring Tide Dr City: Newport Beach
State: CAZip Code: 92660 - ...-Home Phone: ,.......
Owner's Authorized Agent: Tim Carr _.. Work Phone: (gqg) 631-9999
Agent Address: Il450 Newport Center Dr., Ste. 100 City: Newport Beach
State: CA Zip Code: 92660 Agent Email Address: tci@timcarrgroup.com
Escrow Company:) Mariners Escrow corporation
Escrow #: 58616 -BF
Escrow Address: 270 Newport Center Drive, suite 200 City: Newport Beach
State: Fc
A _.. Zip,.Lode: 92660 Escrow Phone: (949) 640-6040
Email Report to: bfoxcroft@marinersescrow.com
For Inspection call (Name): 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/Agent's signature to authorize inspection:
Date:
OR
Owner/Agent's signature to decline inspection: llao S+A un. Gw.M. S+. Nilla:n. Date: 7/8/2020 111:12 AM PDT
Account It 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Bui1din8_B1vis1on\Forms\R3R_9-18-18