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HomeMy WebLinkAboutR2022-0250 - Permits (2)Print Form City of Newport Beach COMMUNITeYY COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT BUILDING DIVISION 7 00 Civic Center Drive i P.O. Box 1768 i Newport Beach, CA 92658-Y4Y51 7 2022 RBR# OZZ- L www.newportbeachca.gov 1 (949) 644-3200 CtT-Y OF Application for Report of Residential Building Recork a, ARDlication Fee: - $198.00 Notice: (For AIIResidential 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: F, Address: 230 Lille Lane, #206 PropertyOwner:l Hunter D Armstrong and Jessie Bird Owner Address: 1 230 Lille Lane, #206 State: ICA Zip Code: F92663 Owner's Authorized Agent: I Darla Gorton Agent Address: 1 30342 Esperanza State: CA Zip Code: 92688 Escrow Company: I Platinum Key Escrow City: Newport Beach State: CA Zip: 92663 Zip Code: 92663 City: Newport Beach Home Phone: I 949-939-4156 Work Phone: 1949-295-7590 City: I Rancho Santa Margarita Agent Email Address: I daria@bullockrussell.com Escrow Address: 131351 Rancho Viejo Rd, Suite 105 State: CA Zip Code:92675 Email Report to: julie@piatinumkeyescrow.com For Inspection call (Name): Escrow #: 1 01 -10914 -JS City: I San Juan Capistrano Escrow Phone: 1949-503-2151 Direct Phone: 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 I will be responsible to correct said violations. DECLINE Owner/Agent's signature to decline inspection: Date: I S Account # 01050504-521040 .................Make checks payoble to: CITY OF NEWPORT BEACH Building Division\Forms\RBR 7121