HomeMy WebLinkAboutR2021-0167 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Application Fee: $194.00 Notice: 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:438 1/2 Carnation Avenue City: Newport Beach ( Corona Del Mar Area ) State: CA
Zip: 92625
Property Owner: The Arnold Family Trust dated January 24 2017
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
Mobil Phone: - Agent Email Address: caseylesherPomail com
Escrow Company: Mariners Escrow Escrow # 60234 -DJ
Escrow Address: 270 Newport Center Drive Suite 200
State: CA Zip Code: 92660
Email Report To: djohnson@marinersescrow.com
For Inspection Call (Name):
City: Newport Beach
Zip Code: 92660
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:
OR 1' ,dj
Owner or Agent's signature to decline inspection e Date:
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH