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HomeMy WebLinkAboutR2023-0513 - Permit ApplicationRECEIVED BY DocuSign Envelope ID: 12AC664C-3EAC-4206-BC11-5CBC5C45CD84 COMMUNITY DEVELOPMENT Print Form City of Newport Beach JUN 092023 COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CITY OF 100 Civic Center Drive I P.O. Box 1768 1 Newport Beach, CA92658-84J*PORT BEACH Rim," Q11pZj — 05 i3 www-newportbeachca.gov ( (949) 644-3200 AP/4 Application for Report of Residential Building Records 9 36 _ /#C.p Application Fee: - $202.00 Notice: (For AIIResidential 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: F Address: 29 Saint Tropez, # 26 PropertyOwner:l WEI DAI owner Address: 1 29 Saint Tropez, #26 State: CA Zip Code: Fq2660 City: Newport Beach State: CA Zip: 92660 Zip code: 92660 City: I NEWPORT BEACH Home Phone; please contact an Agent Joseph Maghami @949-813 1619.. Owner's Authorized Agent: Mina Maghami and Joseph Maghami Work Phone: I Joseph Maghami: 949-813-16 Mina Maghami: 949-874-4020 Berkshire Hathaway HomeServices Agent Address: 1400 Newppn Cenfer Dnvee200 NB, CA92660 City: Newport Beach State: CA Zip Code: 92660 Agent Email Address: Mina - MinaMaghami@gmail.com Joseph - kjmaghami@gmail corn Escrow Company: FcORNERESCROW Escrow Address: F18600 MACARTHUR BLVD #350 State: CA Zip Code: 92612 Escrow #:I 08-11938-VK City: I IRVINE Escrow Phone: I 949-800-8908./ 949-346-2368 Email Report to: ( VESNA KOPAC, Escrow Officer: vesna.kopac@cornerescrow.com For Inspection call (Name): Joseph Maghami @ 949-813-1619 Direct Phone: 949-813-1619 CONSENT TO INSPECT (FORM MUST BE SIGNED & DATED BELOW) [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. DocuSigned by: Owner/Agent's signature to authorize inspection: E vai Date: 6/5/2023 9>FAAVA43r.44— 2 Owner/Agent's signature to decline Date: Z,6 Account # 01050504-521040.................Make checks payable to: CITY OF NEWPORT BEACH auitmn�n�muon\rorms\noa a-ts-zt