HomeMy WebLinkAboutR2021-0581 - Permit ApplicationP:ynt Foi;» City of Newport Beach EIVH-r
COMMUNITY DEVELOPMENT DEPARTMENT " t4hUNITYY
BUILDING DIVISION JPrwENr
Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA9265"@1 f7 202'
RBR# Y� 'J d www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Recofds` Yor
Application Fee: - $198.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $131.00 or incomplete will be returned
Please type or print and complete all information
# of Units: Address: 1418 Sea Ridge Drive City: Newport Beach State: CA Zip: 92660
Property Owner: Edward Chow Zip Code: F 92823
Owner Address: 3470 Villa Drive City: Brea
State: CA Zip Code: F92823 Home Phone: 818-298-0319
Owner's Authorized Agent: Kim Milewski Work Phone: 1 949-300-2706
Agent Address: 9 Drackert Ln City: Ladera Ranch
State: CA Zip Code: F92694 Agent Email Address: kimmilewski@cox.net
Escrow Company: WFG Escrow Escrow #:
Escrow Address: 500 Technology Suite 500 City: FIrvine
State: F CA Zip Code: 92612 Escrow Phone: 949-430-3700
Email Report to: I kimmilewski@cox.net
For Inspection call (Name): Kim Milewski Direct Phone: 949-300-2706
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOWI
I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning
violations are discoveredi will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection:
Mai
Owner/Agent's signature to decline inspection:
Date:
Date: I August 9, 2021
Account # 01050504-521040 ................. Make checks payable to: CITY OF NEWPORT BEACH
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