HomeMy WebLinkAboutR2020-0895 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
www.newportbeachca.gov 1 (949) 644-3200
RBR# &?2WO - O$95
Application for Report of Residential Building Records
Application Fee: $194.00 Notice: Applications with insufficient fee payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_ Address:1215 Bayside Drive #103 City: Newport Beach ( Corona Del Mar Areal State: CA
Zip: 92625 ocrIVEO er
COMMUNITY
Property Owner: Michael Constantin
OCT 1'� REC'D
Owner Address: 740 W. Valencia Mesa Drive City: Fullerton
DEVELOPMENT 0
State: CA Zip Code: 92835 Home Phone:
C, DEVELOPMENT
431*
Owner's Authorized Agent: -- Work Phone:
Agent Address: -, City: - State: CA Zip Code:
Mobil Phone: - Agent Email Address:
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: swelker@marinersescrow.com
For Inspection Call (Name):
Escrow # 59389 -SW
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 Date:
Owner or Agent's signature to decline inspection
IDI I6/ 21) 7-0
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH