HomeMy WebLinkAboutR2021-0250 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT �,CE-lvca 6,y.
BUILDING DIVISION COMMUNrl"Y
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 9265$ 1�5;, �1
www.newportbeachca.gov 1 (949) 644-3200
RBR#
W I-02G%u APR 0 2 2021
Application for Report of Residential Building Recorders
,..
Application Fee: $194.00 Notice: Applications'WiWlii9ticientfee
payment
Reinspection. Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_ Address:712 Fernleaf Avenue City: Corona Del Mar State: CA Zip: 92625
Property Owner: Ibrahim Jamal Marouf Trustee of the Ibrahim Jamal Marouf Trust Dated February 6 2020.
Owner Address: 120 Irvine Cove Circle City: Laguna Beach
State: CA Zip Code: 92651 Home
Owner's Authorized Agent: Garrett Rau Work Phone:
Agent Address: 520 Newport Center Dr. Ste 330 City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: 949-887-5117 Agent Email Address: garrett@garrettrau.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email ReportTo: okennedV(o)marinersescrow.com
For Inspection Call (Name):
Escrow # 60440 -DJ
City: Newport Beach
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
OR
Owner or Agent's signature to decline insp ction Date: W-1 — Z
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH