HomeMy WebLinkAbout20-6-25 Signed appHARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application:
**Property Address:
"Buyer's Names:4' a` Ssa-
Buyer's Signatures:
Billing Address:
Telephone No.:
**Seller's Names
Seller's Signatures
/3
Joint Owner Signature:
**Escrow Company:6�`::PZ'e Phone# %��`7• ��
**Address Z15
**Escrow Number:eg0-4"5101•61)CI If
7 g 2.64/63
**Closing Date (Estimate): 7 • • 2.-0*Email: &J620
/ .r,006 .
.*STARRED ITEMS MUST BE -COMPLETE TO BEGIN THE PROCESS__
Inspection Date: i,i I Z-'31 Z0 Reinspection Date: _
Fee Paid:-�''� Check No: � 70
Application Complete:
Public Works Signature/Date
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
Date:
Inspection Requested By:
Inspector:
Pier Address:
Pier Transfer
INSPECTION FORM
GFI Present
Anti -Siphon / Backflow Present
Other Comments
Comments / Observations
Other Request
Public Works
LLO
I I a t Iboaav-d.
Yes Need None Needed
Reinspection
Yes Need