HomeMy WebLinkAboutR2022-0192 - Permit ApplicationDocuSign Envelope ID: 2D7E3B78-09FB-4617-A6D7-DABB67FF3EED
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Print Fprm City of Newport Beach COMMUNITY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION ,jg�
Y 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 9 -tf�Q A;022
RBR# 1�i�%'% www.newportbeachca.gov 1 (949) 644-3200
CITY OF
Application for Report of Residential Building Rewds c�
PORT ti' '
Application Fee: - $198.00 Notice:
(For AlIResidential Buildings) Applications with insufficient fee payment
Reinspection Fee $131.00 or incomplete will be returned
Please type or print and complete all information
#of Units: F1 Address: 2207 Port. Lerwick. Place City: Newport Beach State: CA .,Zip: 92660
Propertyowner: Ronald G. Paladin & Peta A. Paladin Zip Code: 92660
Owner Address: 2207 Port Lerwick Place city: FNewport_Beach
State: CA Zip Code: 1 92660 Home Phone N/A
Owner's Authorized Agent: Pegi DlRienzo Work Phone 949-230-4663
Agent Address: 12 Corporate Plaza #250 City: Newport Beach
State: F CA Zip Code: F92660 Agent Email Address: pegl@peglshomegroup.com
Escrow company: I Central Escrow Group, Inc.
Escrow Address. 2134 Main Street #185
State: CA Zip Code 92648
Email Report to: I heldi.james@centralescrowgroup.com
For Inspection call (Name): I Pegi Di RIenzo
Escrow #: I CEG907853-HJ
City: Huntington Beach
Escrow Phone: 1 714-698-9982
Direct Phone: 1949-230-4663
CONSENT TO INSPECT (FORM MUST BE SIGNED &-DATED BELOW)
I authorize inspections and re -inspections of the property listed above. I understand that if Building or Zoning
violations are discovered l will be responsible to correct said violations.
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Owner/Agent'sslgnature to authorize inspection: fdrL�'rT�ll��'`�L$!r Cp�� I�s.!'r.:vp{� Date:
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Owner/Agent's signature to decline inspection: I NO. Q• PAWAV- Date:4/5/2022.
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Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Buildin�Division\Forms\RBR 7-1-11