HomeMy WebLinkAboutR2021-0436 - Permit ApplicationCity of Newport Beachcelv�v
COMMUNITY DEVELOPMENT DEPARTMENT coMlquNlTyr
BUILDING DIVISION aevrl o�
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 Mtn17
R262IP01;� www.newportbeachca.gov 1 (949) 644-3200 JUN 14 2021
Application for Report of Residential Building Records +1% o'r)'oh
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Application Fee: $194.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 129.00 or incomplete will he returned
Please type or print and complete all information
# of Units:_ Address:220 Nice Lane. #209 City: Newport Beach State: CA Zip: 92663
Property Owner: The CWM Trust
Owner Address: - City:
State: Zip Code: - Home Phone:
Owner's Authorized Agent: Anna Andrews Work Phone:
Agent Address: 520 Newport Center Dr. #330, City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 274-0132 Agent Email Address: anna.andrews0compass.com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive, Suite 200
State: CA Zip Code: 92660
Email ReportTo: rmiyamoto@marinersescrow.com
For Inspection Call (Name):
Escrow # 60920 -RM
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
OR
Owner or Agent's signature to decline inspection B. Hutchinson for Anna Andrews
Date: June 11, 2021
Account # 2900-5005 ................. Make checks payable to CITY OF NEWPORT BEACH