HomeMy WebLinkAboutR2022-0318 - Permits (2)City of Newport Beach CEIVED
COMMUNITY DEVELOPMENT DEPARTMENTay
COMMUNITY
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915oeVELOPMloPMcva
-770www.newportbeachca.gov 1 (949) 644-3200 JUL 0 5 2022
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Application for Report of Residential Building Record OlTYOF
PORT WIG\"
Application Fee: $198.00 Notice: Applications with insufficient fee
payment
Reinspection Fee $ 131.00 or incomplete will be returned
Please type or print and complete all information
# of Units:_ Address`.207 E. Edgewater Avenue City: Newport Beach State: CA Zip: 92661
Property Owner: Burlingham Revocable Family Trust u/d/t dated 2/12/02
Owner Address: - City:
State: Zip Code: - Home
Owner's Authorized Agent: Chris Moreno Work Phone:
Agent Address: 1400 Newport Center Drive Suite 100 City: Newport Beach State: CA Zip Code: 92660
Mobil Phone: (949) 280-6357 Agent Email Address: cmorenoCcasurterreproperties com
Escrow Company: Mariners Escrow
Escrow Address: 270 Newport Center Drive Suite 200
State: CA Zip Code: 92660
Email Report To: djohnson@marinersescrow.com
For Inspection Call (Name):
Escrow # 63052-DJ
City: Newport Beach
Escrow Phone: 949-640-6040
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.
Owner or Agent's signature to authorize inspection Date: INSPECTION
ram, A OR DECLINED
Owner or Agent's signature to decline inspection
Account # 2900-5005.................Make checks able to CITY OF NEWPORT BEACH