HomeMy WebLinkAboutR2020-0898 - Permit ApplicationPrintm City of Newport Beach Et.
COMMUNITY DEVELOPMENT DEPARTMENT MpJIUpII I
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 I Newport Beach, CA92658-8915
RBR#n 20 - MM www.newportbeachca.gov 1 (949) 644-3200 OCT .). 6 2020
Application Tor Keport OT Kesiaentnal tsuilaing tcecoras. l; -y F,
Application Fee: -$194.00 Notice:
(For All Residential Buildings) Applications withinsufficient fee payment
Reinspection Fee $129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: �i Address: 23 Augusta Lane City: Newport Beach State: CA Zip: 92660
Property Owner: The Shreiar Family Trust Dated July 23, 2002 Zip Code:
Owner Address: 23 Augusta Lane City: Newport Beach
State: CA._ Zip Code: 92660 _ _.. .....Home Phone: 1 C7 Y-1 -Ci 33 - S1,( �
Owner's Authorized Agent: Davar & Co Work Phone: 949.466.4542
Agent Address: 21251 Windstream Circle City; Trabuco Canyon
State: OA Zip Cade: 92679 Agent Email Address: michaei@davarandco.com
Escrow Company:Generations Escrow Escrow #: 101-20634 ^
Escrow Address: 140 Newport Center Drive 4150 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: 949-359-8323',
Email Report to: kinewman@genescrow.com
For Inspection call (Name): 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 responsi ble to correct said violations.
Owner/Agent's signature to authorize inspection: Date:
/ OR
0wner/Agent's signature todeclineinspection f / { ,, Date IZ9,r�
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
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