HomeMy WebLinkAboutR2022-0208 - Permits (2)DocuSign Envelope ID. 3ADDE810-2DF3-46FF-A5A6-88BA6lE1ED90 OCEIVEO @
COMMUNITY
DEVELOPMENT
APR 14 2022
Print Form City of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT CITY OF
BUILDING DIVISION
C 0 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 1,p O`T
RBR# (/ www.newpor beachca.gov 1 (949) 644-3200 ORT BAP
Application for Report of Residential Building Records
Application Fees: Single Family Res/Condo (lunit)- $165.00 Notice:
Duplex (2 Units) - $192.00 Application with insufficient fee payment
More than 2 units - $192.00 + 11.00 per unit over 2 or incomplete will be returned
Reinspection Fee $88.00
Please type or print and complete all information
# of Units: Address: 507 1/2 Carnation Avenue City: Newport Beach State: CA Zip: 92625
Property Owner: Lisa Mahoney, Trustee of the Lisa LM Mahoney Living Trust
Zip Code:
Owner Address:
State: CA Zip Code:
City:
Home Phone:
Owner's Authorized Agent: Danielle Brown Work Phone: (949) 698-1302
Agent Address: 1833 South Coast Highway, Suite 210 City: Laguna Beach
State.CA Zip Code: 92651 Agent Email Address: dbowen@VillaRealEstate.com
Escrow Company: Key Escrow, Inc.
Escrow# 006145-BR
Escrow Address: 450 Newport Center Drive, 230 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: (949)698-1960
Email ReportTo: brandi@keyescrow.com
for Inspection Call (Name):
Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW)
understand that if Building or Zoning
violations are discovered I will be responsible to correct
said violations.
Owner/ Agent's signature to authorize inspe�i'q�1 i..'i� i�d tt Date:
Owner/ Agent's signature to decline inspection: [ p�Ltd Date:
4/14/2022
Account #2900-5005........... Make checks payable to CITY OF NEWPORT BEACH