HomeMy WebLinkAboutR2020-0836 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION Rt Cely , e
100 Civic Center DriveI P.O. Box 1768 INew ort Beach, CA 92658-8915 coMrolrA,rryr
www.newportbeachca.gov 1 (949) 644-3200
RBR# R20Zo -D%3G SEP 24 RECD
Application for Report of Residential Building Record!j� oEVELopAj ,.
Application Fee: $194.00 Notice: Applications with insu flwm @W'
payment
Reinspection Fee $129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: -1— Address:233 20th Street City: Newport Beach State: CA Zip: 92663
Property Owner: The Marvin S.Selcer Family Trust dated January 21, 1985
Owner Address: - City:
State: -Zip Code:- Home Phone:
Owner's Authorized Agent: Brian Sperry Work Phone:
Agent Address: 341 Bayside Drive. City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: - Agent Email Address: brian sperrvresidential.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 # 59312 -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 Date:
Owner or Agent's signature to decline
Account # 290-01-5005 ................. Make checks payable to CITY OF NEWPORT BEACH
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