HomeMy WebLinkAboutR2021-0673 - Permit ApplicationDo%L94 �---*elope ID: B16D2F5E-5601-4108-BOF2-E8CA2DB87C00
City of Newport Beach
Print Form
C0147 te7il?dli'1'
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
�
/) /�I�I�O(II) 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA92656691$ S 2021
RBR# ' V u l lY www.newportbeachca.gov 1 (949) 644-3200
wppiicaiion Tor Keport OY KesKlenval tfullaing
Application Fee: - $194.00
(For All Residential Buildings)
Reinspection Fee $129.00
(11"rV ..�..
Notice:
Applications with insufficient fee payment
or incomplete will be returned
Please type or Print and complete all information
If of Units: F Address: 2392 Bay farm place City: Newport Beach State: FZip:92660
Property Owner: Conrad Yanez Angela Yanez Zip Code: 92660
Owner Address: 2392 Bay Farm Place City: Newport Beach
State: Fc Zip Code: 92660 Home Phone:
Owner's Authorized Agent: I Misty Tracy
Agent Address: 1099 Stewart St. #600
State: WA Zip Code: 98101
Work Phone: I (949) 254-3366
City: I Seattle
Agent Email Address: I misty.tracy@redfin.com
Escrow company: I Corner Escrow, Inc. Escrow #:10 -12744 -AB
Escrowaddress: 118302 Irvine Blvd, Suite 350 City: ITustin
State: CA Zip Code: 92780 Escrow Phone: 714-922-3288
EmailReportto: ashley.bowman@cornerescrow.com
For Inspection call (Name): I 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 orZoning
violations are discovered I will be responsible to correct said violations.
Owner/Agent's signature to authorize inspection:
Date:
OR
DxuBigned by: Docu3igneE by:
Owner/Agent's signature to decline inspection: F FE Date: 9/8/2021
23886BFE EED43A... �-
238BBBFEAEED43A...
Account # 01050504-521040 .................Make checks payable to: CITYOF NEWPORTBEACH
Bulld.,M Wn\Farms\RBR 2-30.20