HomeMy WebLinkAboutR2021-0221 - Permit ApplicationCITY OF NEWPORT BEACH
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 9265$9151
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RBR # www.newportbeachea.gov (949)644-3200
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SPORT Of -No
Application for Report of Residential Building Records
Application Fee: $194.00 Notice:
(For All Residential Buildings) Application with insufficient fee payment
Reinspection Fee $125.00 or incomplete will be returned
Please type or print and complete all information
Number of units: Street Address: 70 Sea Island Drive
Property Owner: AHW Alton LLC Zip Code:
Owner Address: I Q �'y®Ly j�n A � o P !N J`� 612 �&
((yy\ @ /� Street City /(��� ((�//^yy 2 Zip
Home Phone: " All — a3 0 ` `�jC7/ Work Phone: "l (- - 1 _ o — 11`1 —L—
Owner's Authorized Agent: BRYN DEBEIKES, COLDWELL BANKER REALTY
Agent Address: 840 NEWPORT CENTER DR, STE 100, NEWPORT BEACH, CA 92660
Work Phone: 949 640-3600
Escrow Name and Address: West Coast Escrow, Escrow No. 4530621-02752 - LS
Escrow Address: 840 Newport Center Drive, Suite 150 , Newport Beach 92660 Escrow Phone: (949) 759-7072
Email Report to: LAURA. STEIN ER@WESTCOASTESCROW.COM
For Inspection Call (Name): Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND 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 signature to authorize inspection Date
OR
Owner/Agent's signature to decline inspection 14 z Date
Account #01050504-521040............ Make checks payable to CITY OF NEWPORT BEACH
Who- fQQQrrr inspect' (`1^� V y
Name tC) (� \ Z" Direct Phone: I l 3