HomeMy WebLinkAboutR2021-0161 - Permit ApplicationDocuSign Envelope ID: D60938C2-2120-4464-A29D-F60395CD9C8B
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Work Phone: (949) 717-6000
City of Newport Beach
City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address:
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
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www.newportbeachca.gov 1(949) 644-3200
Application for Report of Residential Building Records
Application Fees: Single Family Res/Condo (1 unit) - $165.00 Notice:
Duplex (2 Units) - $192.00 Application with insufficient fee payment
More than 2 units - $192.00 + 11.00 per unit over 2 or incomplete will be returned
Reinspection Fee $88.00
Please type or print and complete all information
# of Units: Address: 214 Garnet Avenue City: Newport Beach State: CA Zip: 92662
Property Owner: 214 Garnet Avenue, LLC Zip Code:
Owner Address: City:
State: CA Zip Code: Home Phone:
Owners Authorized Agent: Jeanne Carni
Work Phone: (949) 717-6000
Agent Address: 450 Newport Center Dr., Ste. 100
City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address:
Escrow Company: Key Escrow, Inc.
Escrow # 005371 -BR
Escrow Address: 450 Newport Center Drive, 230
City: Newport Beach
State: CA Zip Code: 92660
Escrow Phone: (949) 698-1960
Email Report To: brandi@keyescrow.com
for Inspection Call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections of the property listed above.
violations are discovered I will be responsible to correct said violations.
Owner/ Agent's signature to authorize inspection: r Date:
Owner/ Agent's signature to decline inspection: i J�^'�""''�`�'"" Date:
3/3/2021
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH
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