HomeMy WebLinkAboutR2021-0272 - Permit Applicationpe.vC"VI-11
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COMMIJNITY
Print Fora, City of Newport Beach DEVtIOPMEINl,
COMMUNITY DEVELOPMENT DEPARTMENT APR p 8 2021
BUILDING DIVISION
yin r� a 100 Civic Center Drive I P.O. Box 1768 Newport Beach, CA 92658-89G15yo1
RBR# 9� wl, www.newportbeachca.gov (949) 644-3200
Application for Report of Residential Building Records
Application Fee: - $194.00 Notice:
(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: 222 Via Koron City: Newport Beach State: [CA Zip: 92663
Property Owner: Magnum Property Investment, LLC Zip Code: F91301
Owner Address: P.O. Box 1136 City: Agoura Hills
State: CA Zip Code: 376
91Home Phone:
Owner's Authorized Agent: Steven Bud Mastropaolo Work Phone: 714 655-6584
Agent Address: 980 W. Coast Hwy, #200 City: Newport Beach
State: FCA Zip Code: F92663 Agent Email Address: bud@oceaneolleetive.com
Escrow Company: I Connect Escrow, Inc.
Escrow#: 105910 -KJ
Escrow Address: 127509 Agoura Road #210 City: I Agoura Hills
State: FCA Zip Code: F91301 Escrow Phone: 818 374-5440
Email Report to: Katie@connectescrow.com
For Inspection call (Name): ^� ,/��tCd t-" , +ro oto 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/Agent's signatureto authorize inspection:
Date: I
Owner/Agent's signatureto decline inspection: Dater
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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