HomeMy WebLinkAboutR2023-0189 - PermitsRECEIVED BY
COMMUNITY
Print Form City of Newport Beach DEVELOPMENT
COMMUNITY DEVELOPMENT DEPARTMENT MAR 0 8 ZOZIJ
BUILDING DIVISION
100 Civic Center Drive I P.O. Box 1768 Newport Beach, CA 92658-8915-ITY OF.
RBR# (2,zOS5 - C)ls O� www.newportbeachca.gov (949) 644-3200 NEWPORTBEAC14
Application for Report of Residential Building Records
Application Fee: - $202.00 Notice:
(For All Residential Buildings) Applications with insufficient fee payment
Reinspection Fee $134.00 or incomplete will be returned
Please type or print and complete all information
# of Units: F1 v Address: 1 306 Sapphire Avenue
Propertyowner:I The Etienne Family Trust
Owner Address:
State: CA Zip Code:
Owner's Authorized Agent:
Agent Address:
State: F Zip Code: F
City: Newport Beach State: CA Zip:r2662
City: I
Home Phone:
Work Phone:
City: I
Agent Email Address: F-
Zip Code: I
Escrow Company: Freedom Escrow Escrow #: 055731-MM
Escrow Address: 11200 Newport Center Dr., Suite 180
State: I CA Zip Coclef 92660
Email Report to: I mm@freedomescrow.com
For Inspection call (Name): I N/A
City: Newport Beach
Escrow Phone: I (949) 644-3939
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/Agent's signature to authorize inspection: Date:
OR
Owner/Agent's signature to decline v. 1 Date: fJ
Account # 01050504-521040 .................Make checks payable to: CITY OF NEWPORT BEACH
Building_Division\Form s\RBR_6-15-22