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HomeMy WebLinkAboutR2020-0524 - Permit Application,: OGIVk'iU 91 DocuSign Envelope ID: BAA8FCFB-D896-456D-AICD-59E2EE6BABF8 �tJMtJiUNITY k x -s t, Y ') VF_I:OPMENT ycn City of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT UN 2 9 2020 BUILDING DIVISION 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA92658-8.915 RBR# 1 �"'� "- ' www.newportbeachca.gov 1 (949) 644-3200 CITY©F 4 l Application for Report of Residential Building RecoragRT 11" Application Fee: -$191.00 Notices (For All Residential. Buildings). Applications with insufficient fee payment Reinspection Fee $129.00 or incomplete will be returned Please type or print and complete all information #of Units: Address: 938 via Lido Soud City: Newport Beach State: CA 'Zip: 92663 Property Owner: ._..Keith R. Lumpkin._.and Leonie Lumpkin „! ZipCode:F —, Owner Address: 938 Via Lido Soud City: FNewport Beach State: CA Zip Code: 92663 Home Phone: ._..... . ..... Owner's Authorized Agent:Ti», -w Tim Carr i Work Phone: (949) 631-9999 - Agent Address: 450 Newport Center Dr, #100 City: Newport Beach State: F„CA Zip Code:9266o Agent Email Address: tci@timcarrgroup.com Escrow Company:) Mariners Escrow/Brian Foxcroft Escrow #: Escrow Address: 270 Newport Center Drive, Suite 200 City: FNewport Beach State: CA Zip Code: F92660 Escrow Phone: (949)719 2113 Email Report to: tci@timcarrgroup.com, 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 correctsaid violations. Owner/Agent's signature to authorize inspection: Date: OR E, sia•a ey: Owner/Agent's signature to decline inspection: E,+ Aw Tim Carr Date: 6/29/2020 I 8:51 AM v. o.asecsnuefe... .... ....._.., Account # 01050504-521040 .................Make checks payable to: OTYOF NEWPORT BEACH 8ui1din,DM,r..v.rms\ABR_9-18-18 9111