HomeMy WebLinkAboutR2021-0806 - Permit ApplicationDocuSign Envelope ID: E669COA4-FOEB-4951-AO89-42715250109D
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Print Form City of Newport Beach
COMMUNITY DEVELOPMENT
DEPARTMENT
BUILDING DIVISION
SIGN
uITY D
711 l�,9`Q'10 is Center Drive I P.O. Box 1768 Newport Beach, CA 92658-8915
RBR# t—✓� V 1-6�(/�J �X www.newportbeachca.gov (949) 644-3200
Application for Report of Residential Building Records
Application Fees: Single Family Res/Condo (lunit)-$198 Notice:
Application with insufficient fee payment
or incomplete will be returned
Please type or print and complete all information
# of Units: Address: 534 Catalina Drive City: Newport Beach State: CA Zip: 92663
Property Owner: Peter Spenuzza III Zip Code:
Owner Address: City:
State: CA Zip Code: Home Phone:
Owner's Authorized Agent: John Stanaland Work Phone: (949) 717-6000
Agent Address: 450 Newport Center Dr., Ste. 100 City: Newport Beach
State:CA Zip Code: 92660 Agent Email Address:
Escrow Company: Key Escrow, Inc. Escrow # 005980 -BR
Escrow Address: 450 Newport Center Drive, 230 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: (949)698-1960
Email Report To: brandi@keyescrow.com
for Inspection Call (Name): Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
I authorize inspections and re -inspections of the property listed above.
violations are discovered I will be responsible to correct said violations.
Owner/ Agent's signature to authorize inspection: Date:
Owner/ Agent's signature to decline inspection: 9dV SPIII Date:11/23/2021
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH
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