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HomeMy WebLinkAboutR2020-0921 - Permit ApplicationPrint Form City of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 RBR# J� O •-u 4�t ` www.newportbeachca.gov 1 (949) 644-3200 Application for Report of Residential Building Records Application Fee: - $194.00 Notice: (For All Residential Buildings) Applications with insufficient fee payment Reinspection Fee $129.00 or incomplete will be returned Please type or print and complete all information #ofUnits: I Address: F28 Dunes Bluff City: Newport Beach State: CA Zip: F 92657 Property Owner: EuroPacifc Property Investment LLC Zip Code: 92651 Owner Address: 1000 North Coast Hwy Suite # 1 City: FLaguna Beach State: CA Zip Code: F92651 Home Phone: (949) 524-9162 Owner's Authorized Agent: Work Phone: I Agent Address: I City: State: F Zip Code: F Agent Email Address: Escrow Company: I Encore Escrow Company, Inc. Escrow #: I 01441 -PJ Escrow Address: I 9200 Sunset Blvd. # 207 City: I West Hollywood State: F CA Zip Code: 90069 Escrow Phone: (310) 461-0480 Email Report to: Peter Joun - Peter@EncoreEscrow.com For Inspection call (Name): Patrick Piens Direct Phone: 1 (949) 524-9162 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 responsibleto correct said violations. Owner/Agent's signature to authorize inspection: Owner/Agent's signature to decline inspection: Building_ Divisionvorms\11BR_7 30-20 Date: Date: November 2, 2020 Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH