HomeMy WebLinkAboutR2021-0258 - Permit ApplicationPrint Farm City of Newport Beach EVECOMLP EN
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COMMUNITY DEVELOPMENT DEPARTMENT
r BUILDING DIVISION IPPR ® 6 2021
100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA92658-8915
RBR#y www.newportbeachca.gov 1 (949) 644-3200
CITYOF
Application for Report of Residential Building Recon,.,„-_
Application Fee: - $194.00
(For All Residential Buildings)
Reinspection Fee $129.00
#ofUnits: Address:
Notice:
Applications with insufficient fee payment
or incomplete will be returned
Please type or print and complete all information
16 Rockshore Bluff CN: Newport Beach State: Zip: 82657
PropertyOwner: ,fin Y. Chang, Trustee of Bre J888C Trust Dated Deaxnher 16, 2008
Owner Address: 16 Rocimhora Bluff City: tiexport Coast
State: �— Zip Code: 92657
Zip Code: F
Home Phone: 949.813.9393
Owner's Authorized Agent: Judy Chang Work Phone: 4243.43-3438
Agent Address; 202 N. Cannon Dr. City: ;every FNAs
State: FCA Zip Codes 90210 Agent Email Address: bhre($me.com
Escrow Company: Padfic Esam Escrow #: F021006 -PE
Escrow Address: 1 2100 Main St. Ste 102
City: irdFe
State: FCA Zip Code: W614 Escrow Phone: F626416,5511
Email Report to: fila@jcpdnc.com
For Inspection call (Name): Use Chiang Direct Phone: F
CONSENT TO INSPECT IFORM 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 1 will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection:
Date: F—
OR
Owner/Agent's signature to decline inspection: --'—'Date: /p( 107-I
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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