HomeMy WebLinkAboutR2020-0545 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT vED
BUILDING DIVISION MMUNIY Y
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915()FVFLOPMEN"1
www.newportbeachca.gov 1 (949) 644-3200
,JUL 01 2020
RBR# -102?J .(7"6
Application for Report of Residential Building Records
CITY OF
Application Fee: $191.00 Notice: Applications with insIWREIIEA4ee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:1 Address:2319 Margaret Drive City: Newport Beach State: CA Zip: 92663
Property Owner: John and Jackie Melbon Family Trust dated September 19 2002
Owner Address: - City:
State: Zip Code: _ Home Phone:
Owner's Authorized Agent: Cassie Hammond/ Chris Moreno Work Phone:
Agent Address: 1400 Newport Center Drive Suite 100, City: Newport Beach
State:
CA
Zip Code: 92660
Mobil Phone: (949) 500-5569 Agent Email Address: chammond@surterreproperties.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: djohnson@marinersescrow.com
For Inspection Call (Name):
Escrow # 58561 -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
OR
Owner or Agent's signature to decline inspection
Account # 2900-50d05.................Make ch cks_payable to CITY OF NEWPORT BEACH
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