HomeMy WebLinkAboutR2023-0230 - Permit ApplicationH0V381WMM3N
City of Newport Beach 40A110
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION i ai)a ti 7
100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915 1N3Wd013A30
Fib&# www.newportbeachca.gov l (949) 644-3200 AUNnwwoo
Application for Report of Residential Building Records AS a3A13O3b
Application Fee: - $202.00 Notice:
(For All Residential Buildings) Application with insufficient fee payment
Reinspection Fee $134.00 or incomplete will be returned
Please type or print and complete all information
# of Units: 1 Address: 14 Skysail Drive City: Newport Beach State: CA Zip: 92625
The Constance A. Ruhe Trust established September 3,
Property Owner: 2003 Zip Code: 92625
Owner Address: 14 Skysail Drive City: Newport Beach
State: CA Zip Code: 92625 Home Phone:
Owner's Authorized Agent: Suzanne Wyrick Work Phone: 949-466-3161
Agent Address:
3 Curl Drive
City:
Newport Beach
State: CA
Zip Code: 92660
Agent Email Address:
SUZ9921@GMAIL.COM
Escrow Company: West Coast Escrow Escrow #: 4530623-01520 -
Escrow Address: 840 Newport Center Dr., Ste.150 City: Newport Beach
State: CA Zip Code: 92660
Email Report to: teamnewport@westcoastescrow.com
Escrow Phone: (949) 759-7072
For Inspection call (Name): n/a Direct Phone:
CONSENT TO INSPECT (FORM MUST BE SIGNED AND 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:
[H:
Owner/Agent's signature to decline inspection: Suzclnm W�rtcle
Account#01050504-521040............ Make checks oavable to: CITY OF
Date
Date os/22/2-..
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