HomeMy WebLinkAboutR2023-0242 - Permit ApplicationBY
Print Form City of Newport Beach COMMUNfrrY
COMMUNITY DEVELOPMENT DEPARTMENT DEVELOPMENT
BUILDING DIVISION MAR 2 7 2023
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-8915
FlOtf - Z2o 2-3 - 07-Li2- www.newportbeachca.gov 1 (949) 644-3200 CITY OF
Application for Report of Residential Building itacnrrlc NEWPORTI)EACH
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: I ' Address: 501 Morning Canyon Road #8 City: Newport Beach State: CA Zip: 92625
Propertyowner: Michael Oh Zip Code: F—
Owner Address: City:
State: �— Zip Code: F Home Phone: �—
Owner's Authorized Agent: Work Phone: �—
Agent Address: City:
State: �— Zip Code: F Agent Email Address:
Escrow Company: Freedom Escrow Escrow#: 055745-MM
EscrowAddress: 1200 Newport Center Dr., Suite 180 City: I Newport Beach
State: FCA Zip Code: 92660 Escrow Phone: (949) 644-3939
Email Report to: mm@freedomescrow.com
For Inspection call (Name): I N/A 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 47 Z
?
.................maKe checks payable to: CITY OF NEWPORT BEACH
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