HomeMy WebLinkAboutR2020-0806 - Permit ApplicationCity of Newport Beach `' {
COMMUNITY DEVELOPMENT DEPARTMENT`: ram
BUILDING DIVISION �11 � ` 41
pp GG 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 9261W-8 k
RBR# FZ(}2(7' 06010 www.newportbeachca.gov 1 (949) 644-3200 �.
Application for Report of Residential Building Records n'7T e r cM
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
# of Units: r1 !! Address: 3106 Corte Marin City: Newport Beach 1, State: CA IZip: 92660
- - - - - ---
awrence Iger an Jocelyn Iger, Trustees o t e
Property Owner: Zip Code: 92660
Kliger Living_ Trust.dated.July-18, 2002
Owner Address: 3106 Corte Marin City: F Newport Beach
State: 1. CA Zip Code: 92660 Home Phone. (949) 640-0498
Owner's Authorized Agent: harry Allen Kliger
Agent Address: 2549 Eastbluff Drive #362
Work Phone: (909) 992-0987
City: Newport Beach
State: CA Zip Code: 1 92660 Agent Email Address: LKliger@La-Assoc.corn
For Inspection call (Name): Marcia Esswem Direct Phone: (714) 964-2244
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:
OR
Owner/Agent's signature to decline inspection:
Account # 01050504-521040 .................Make
B.Ildln�DI.Isl.n\F.r ,NRBR_7-3030
Date:
Date: 9/21/2020
to: CITY OFNEWPORTBEACH