HomeMy WebLinkAboutR2020-0804 - Permit Applicationiveb
PrinrForm. City of Newport Beach ;vOM;vUNIly
COMMUNITY DEVELOPMENT DEPARTMENT ul vE oprv`-�Q
BUILDING DIVISION cgp , mo
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ca 100 Civic Center Drive I P.O. Box 1768 Newport Beach, CA92658 8915
RBR# � cl/ Q— 01A www.newportbeachca.gov i (949) 644-3200
for Report of Residential
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Application Fee: 194.00 Notice:
(For All Reside Y gs Applications with insufficient fee payment
Reinspection Fee $129.00 or incomplete will be returned
Property Owner. Russell Kent Howell _ ... . .
Owner Address: I613Jasmineave City: I Newport Beach
State: F Zip Code: F 92625 Home Phone: 94975M819
Zip Code: F92625
Owner's Authorized Agent: Paula McKinney Work Phone: 949252-9789
Agent Address: 459 Newport center Dr #1 00 City: Newport Beach
State: ��' Zip Code: F92660 Agent Email Address:
PeubmfiNnMW®YaM1m.mn '
Escrow Company: FIRST AME RICAN TITLE Escrow #: I 6367418
Escrow Address: 4 First American Way City: Santa Ana
State: ea Zip Code: 92701 Escrow Phone: 7142503025
Email Report to: I kmullikir@firstam.com
For Inspection call (Name): ROsaeuNowefi Direct Phone: 9a975MB19
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/Agent's signature to authorize inspection: Date:-
OR
Owner%Agen't's signature to'declineinspection: j� ���U Date:
111 __ .. .___in'n/Ic111C1A/0l1OTQLAGi'u
Account # 01u!)uW4-D/lv4v ................. rvwnc �nc��+f"'/. � � ••
Building_Divislon\Forms\RaR 7-30.20
Please type or
print and complete all information
# of Units: 2 ;Address:
;City: Newport Beach
State: CA ;Zip: 82625
513 and 513 1/2 Jasmine Ave ..
Property Owner. Russell Kent Howell _ ... . .
Owner Address: I613Jasmineave City: I Newport Beach
State: F Zip Code: F 92625 Home Phone: 94975M819
Zip Code: F92625
Owner's Authorized Agent: Paula McKinney Work Phone: 949252-9789
Agent Address: 459 Newport center Dr #1 00 City: Newport Beach
State: ��' Zip Code: F92660 Agent Email Address:
PeubmfiNnMW®YaM1m.mn '
Escrow Company: FIRST AME RICAN TITLE Escrow #: I 6367418
Escrow Address: 4 First American Way City: Santa Ana
State: ea Zip Code: 92701 Escrow Phone: 7142503025
Email Report to: I kmullikir@firstam.com
For Inspection call (Name): ROsaeuNowefi Direct Phone: 9a975MB19
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/Agent's signature to authorize inspection: Date:-
OR
Owner%Agen't's signature to'declineinspection: j� ���U Date:
111 __ .. .___in'n/Ic111C1A/0l1OTQLAGi'u
Account # 01u!)uW4-D/lv4v ................. rvwnc �nc��+f"'/. � � ••
Building_Divislon\Forms\RaR 7-30.20