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HomeMy WebLinkAboutR2021-0756 - Permit ApplicationPrint Form City of Newport Beach COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION ��/��I , /� r i1�0 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915 RBR# l/ 1 v l "J �,l' www.newportbeachce.gov 1 (949) 644-3200 Application Tor Report of Residential Building Records Anolication 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: I ' Address: 25 Canyon Island Drive City: Newport Beach State: CA ZZip: 92660-51151 Propertyowner: Alex and Jennifer Froemke Zip code: F92660 Owner address: 1 25 Canyon Island Drive city: Newport Beach State: FCA zip Code: 92660 Home Phone: 1 714-812-6743 Owner's Authorized Agent: Jennifer Froemke Work Phone: 714-812-6743 Caldwell Banker Realty, Huntington Beach Agent Address: I 19440 GOldenwest St. city: FHuntington Beach State: FCA i Zip Code: 92648 Agent Email address: I jennifer.froemke@cbrealty.com Escrow Company: I CORNER ESCROW INC. Escrow#:I 08-10676-VK Escrow Address: 18600 MACARTHUR BLVD.#350 City: FRVINE State: CA Zip Code: F92612 Escrow Phone: 1 949-800-8908 Email Report to: vesna.kopac@cornerescrow.com and jennifer.froemke@cbrealty.com For Inspection call (Name): Jennifer Froemke Direct Phone: 1 714-812-6743 CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW) I authorize inspections and re -inspections of the property listed above. I understandthat if Building or Zoning violations are discovered I will be responsible to correct said violations. Owner/Agent's signature to authorize Inspection 1 Bate: to I '251 Z / OR —"` Owner/Agent's signature to decline inspection: ,/ Date: .................MaKe Cnecxs payable to: CITY OF NEWPORT BEACH awiair�a�won\ro.�Urea_Z.vai