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COMMUNITY
DEVELOPMENT
04 ": City of Newport Beach APR 06 2022
.£ " COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
Q 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-86W Or
www.newportbeachca.gov 1 (949)644-3200 �FhoORT 5SO
-v—. Dem~+ of Rarzidential Building Records
Please type or print and complete all information
�; Address: _City: ,Newport Beach State: CA ;Zip: 92663
# of Units: 255 101 Scholz #125__.
Zip Code 92866
Property Owner: Jonathan -- Mink and Audrey I Mink ---------
------------
Owner Address City: Orange
533 E Jefferson Avenue
Home Phone F714-553-2950
State: FCA Code: 52866
work Phone:
Owner's Authorized Agent: I
Agent Address: 740 EI Camino Real #201 _ City: Tustin
State: FCA _ Zip Code: �92780� Agent Email Address: homestla OwnitNowRealty_c_om
Escrow #: 026436 -KE
Escrow Company: Raincross Escrow --
Escrow Address: 3230 E. Imperial Hwy #200 City: F Brea
State: „ ,CA Zip Code: 92821
Escrow Phone F714-924-3395
Email Report to: F--,.,_kevin@raincrossescrow.com -----`-- " �
Direct Phone: 714-720-6643
For Inspection call (Name): Eric Perez
CONSENT TO INSPECT FORM MUST BE SIGNED I DATED BELOWI
violations are discovered I will be responsible to correct said violations.
Dn..Stgn.d by'
Owner/Agent's signature to authorize inspection _ Date:
OR
Owner/Agent's signature to decline inspection: Date: F
Account # 01050504-521040 ............ ..Make checks payable to: CITY OF NEWPORT BEACH
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