HomeMy WebLinkAboutR2020-0909 - 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# Q020 - 0909
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:20292 SW Cypress Street City: Newport Beach State: CA Zip: 92660
Property Owner: Schneider Family Trust dated JanuarX29 1979
Owner Address: 20292 SW Cypress Street City: Newport Beach
State: CA Zip Code: 92660 Home Phone:
Owner's Authorized Agent: Carter Kaufman Work Phone:
Agent Address: 1804 Newport Blvd.. City: Costa Mesa State: CA Zip Code: 92627
Mobil Phone: - Agent Email Address:
Escrow Company: Mariners Escrow Escrow # 59456 -SW
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email Report To: swelker@marinersescrow.com
For Inspection Call (Name):
City: Newport Beach
Escrow Phone: 949-640-6040
R€Cc'lV(^V
OIL-
Ct'tfut�hary
OCT 2A"�
G
pkFVE�opMEjvT
G
Direct Phone: "�VPQRT SEP
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
Owner or Agent's signature to decline inspection Date:
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH