HomeMy WebLinkAboutR2020-0541 - Permit ApplicationwG-NEll gl,
City of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION 1, MIDI 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-89juL o
RBR# �� i)J`c� www.newportbeachca.gov 1 (949) 644-3200
CITY OF
Application for Report of Residential Building Records
..?I/PDft'i 0
Application Fee: - $191.00 Notice:
(For AIIResidential Buildings) Applications with insufficient fee payment
Reinspection Fee $129.00 or incomplete will be returned
Please type or print and complete all information
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# of Units �' Address: 220 Heliotrope city: Newport BDs
eac I cats: ICA jZip] 92625
Propertyowner: Jeff or TerryZwarts i Zip Code:
Owner Address: ! City:
State: CA _ _ - Zip Code: F7777 Home Phone: �._
Owner's Authorized Agent: Patty Presson / Janice Arrigo Work Phone: 949.922.0520
i
Agent Address: City:
State: F-1 I� Zip Code F-1. Agent Email Ad
dress:
ArngoPresson@SurterrePraperties.com
Escrow company: BLUE WATER ESCROW Escrow #
Escrow Address: 1400 NEWPORT CENTER DRIVE, SUITE 100 City: NEWPORT BEACH, CA 92660
State:F i Zip Code:F777 Escrow Phone 949 478 7900
Email Report to:ArrigoPresson@SurterreProperties.com jason@bluewaterescrow.com
For Inspection call (Name): I Direct Phone:
I
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:
Owner/Agent's signature to decline inspection:
Building DNklnn\Farms\RBR_9-18-18
Date:
OR
GzuuGLh Date:6/23/2020
Account # 01050504-521040 .................Make checks payable to: CRT OF