HomeMy WebLinkAboutR2020-0828 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION 1-01/WUNITY
q 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA9298-6J16P
RBR# R 2020 -OCL www.newportbeachca.gov 1 (949) 644-3200 SEP 2 5 mo
Application for Report of Residential Building Res- . s_
f
Application Fee: - $194.00 Notice: `clypORsRO\
(For All Residential Buildings) Applications with msicient
7.oe:..�..e..w .... cnn C is 90 nn .. __._____r_._..:. I—
Please type or print and complete all information
# of Units: Address: 441 Seville Avenue City: Newport Be77
ach I State. CA ,Zip: 92661
.............__._._.._ ._._J .. ............._I
Propertyowner: Eric K. McCoy Zip Code: 92661 I
Owner Address: 441 Seville Avenue City: I Newport Beach
State: CA Zip Code: 92661 E Home Phone 714-227 9876 j
Owner's Authorized Agent Adrienne Grandes work Phone: 949-690-3918
Agent Address: 1400 Newport Center Drive, #100 City: Newport Beach
State: CA Zip Code 92660 Agent Email Address: abrandes@surterreproperties.com
Escrow Company: The Escrow Firm Escrow #: 21992 -KO
Escrow Address: 30231 Golden Lantern, A City; Laguna Niguel
_. I
State: Fm�—� Zip Code: F§29777 Escrow Phone: 949-249-4060
C
Email Report to: LXQ r lJV.. J_OWX��, U
For Inspection call (Name): L Y l�V Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspectionsand re-inspectionsof the property listed above. I understand that if Building or Zoning
violations are discovered l will be responsible to correct saidviolations.
Owner/Agent's signature to authorize inspection: Date,
OR
Owner/Agent's signature to decline inspection: < Date:. !` 7
Account # 01050504-521040 .................Make checks payable : CITY OF NEWPORT BEACH CEJ
Bulldin�Division\Forms\RBR 1-30-20