HomeMy WebLinkAboutR2020-0852 - Permit ApplicationCity of Newport Beach REcely
COMMUNITY DEVELOPMENT DEPARTMENT �0@
BUILDING DIVISION Cp
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 "fAlNNtry
www.newportbeachca.gov 1 (949) 644-3200 OC% ro 7
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Application for Report of Residential Building Recorok
Application Fee: $194.00 Notice: Applications with insufficient fee
payment
Reinsuection Fee $ 129.00 or incomplete will he returned
Please type or print and complete all information
# of Units:1 Address:228 Hazel Drive City: Newport Beach( Corona Del Mar Area) State: CA Zip:
92625
Property Owner: Brad Robert Prescott Living Trust dated Novemberr 18 1999
Owner Address: - City:
State: _Zip Code:- Home
Owner's Authorized Agent: Casey Lesher Work Phone:
Agent Address: 840 Newport Center Dr. #100, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: - Agent Email Address: caseylesher gmail.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 # 59366 -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
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Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH