HomeMy WebLinkAboutR2020-0872 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
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Application for Report of Residential Building Records
Application Fee: $194.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:1 Address: 15 Del Mar City: Newport Beach( Newport Coast Areal State: CA Zip: 92657
Property Owner: The Mark DoneaanTrust Dated June 16 2006 and The Pamela Donegan Trust Dated June 16 2006
Owner Address: - City:
State: Zip Code: - Home Phone:
Owner's Authorized Agent: Rob Giem Work Phone:
Agent Address: 520 Newport Center Dr. Ste 330 City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: - Agent Email Address: rolb@robciiem.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 # 59388 -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
Owner or Agent's signature to decline
10-S
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH
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