HomeMy WebLinkAboutR2021-0767 - Permit ApplicationCity of Newport Beach
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION
pA 0Qjvic Center Drive I P.O. Box 1768 1 Newport Beach, CA 92658-8915
RBR # ��ff www.newportbeachca.gov 1 (949) 644-3200
Application for Report of Residential Building Records
Application Fee: - $198.00 Notice:
(For All Residential Buildings) Application with insufficient fee payment
Reinspection Fee $131.00 or incomplete will be returned
Please type or print and complete all information
# of Units: 1 Address: 223 Via Nice
Property Owner: The Rambeau
Owner Address:
State: CA Zip Code:
Owner's Authorized Agent: Diana Miner
City: Newport Beach State: CA Zip: 92663
Trust dated July 29, 1996
City:
Home Phone:
Work Phone: 949)394-6212
Zip Code:
Agent Address:
840 Newport Center Dr. #100
City:
Newport Beach
State: CA
Zip Code: 92660
Agent Email Address:
daminer99@aol.com
Escrow Company: West Coast Escrow Escrow #: 4530621-10613 -
Escrow Address: 840 Newport Center Drive, Suite 150 City: Newport Beach
State: CA Zip Code: 92660 Escrow Phone: (949) 759-7072
Email Report to: teamheben@westcoastescrow.com
For Inspection call (Name): Diana Miner
Direct Phone: 949)394-6212
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: Date/O,,
y
Owner/Agent's signature to decline inspection:
Date
Account #01050504-.'i91 nonr .,
Buildi�WAOR\F mS\RBR-7-1-21