HomeMy WebLinkAboutR2021-0414 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION ;awt.;GlvCj
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8916'101,11,4UMT"
/p qq www.newportbeachca.gov 1 (949) 644-3200
RBR# 24 L JUIN, 0 4 2021
Application for Report of Residential Building Records
Application Fee: $194.00 Notice: Applications wi4h`Ifn y 'ct900ee
payment
Reinspection Fee $ 129.00 or incomplete will be returned
Please type or print and complete all information
# of Units: Address:2152 E. Oceanfront City: Newport Beach State: CA Zip: 92661
Property Owner: Skydweller LLC
Owner Address: - City:
State: Zip Code: - Home
Owner's Authorized Agent: Tata Foster -Shapiro Work Phone:
Agent Address:
1200 Newport Center Drive Suite 100
City:
Newport
Beach State: CA
Zip Code: 92660
Mobil Phone: -
Agent Email Address: tshapiro(o)homgroup
com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive Suite 200
State: CA Zip Code: 92660
Email Report To: djohnson@marinersescrow.com
For Inspection Call (Name):
Escrow # 60867 -DJ
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:
OR
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Owner or Agent's signature to decline inspection X Date: �J
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH