HomeMy WebLinkAbout25-03-05 Complete App & InspDate:
Inspection Requested By
Inspector:
Pier Address:
Pier Transfer
INSPECTION FORM
Public Works
112_61�5
-3M
400 '/Z <_ l4k.mr
Reinspection
GFI Present Yes Need None Needed Yes Need
Anti -Siphon / Backflow Present
Other Comments
Comments / Observations
Other Request
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application:
**Property Address: w�� �/y CMGWoVuWVv PA-0
NV-,,rqU✓X t;,� CA o? L,3
**Buyer's Names: (_ A W-' `�)c fty2-Wy✓v
Buyer's Signatures:
Billing Address:
Telephone No.:
**Seller's Names: l wr "K46, owx actd S
Seller's Signatures: =ram
Joint Owner Signature:
**Escrow Company:_gX,0Avv\, Q5 vwo,-J Phone# V-303c-1
**Address 13,40 N!n"yV O wNN C/ �1 Jao
**Escrow Number:
**Closing Date (Estimate): )-1;V1) �-5—**Email: !_'11� '�kl�Wow 1 CuWL
*-*STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: L/zb/1 s Reinspection Date:
Fee Paid: C�k No: o00651� 4
Application Complete:
ublic Works Signature/Date
Special Conditions: This pen -nit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Drive
Newport Beach, CA 92660
949-644-3044
**Date of Application: y f 1� ( ?�
**Property Address: _ 400 Vy W*V',�W PA'f-)
VWgUV-Y 6-� CA 01 3
**Buyer's Names:
Buyer's Signatures:
Billing Address:(
Telephone No.:
**Seller's Names: _ t wffi!21 Km oyyc- c4y_� Y. j�,G►� S
Seller's Signatures:
Joint Owner Signature:
**Escrow Company: �,tM- CA- Wovi Phone# ��I' tAr3,cl3ct
**Address[7,4d NML'& BV
**Escrow Number:
**Closing Date (Estimate): ;- 0-1 I 7-S—**Email• 1� vVd,,i Lom
*-*STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: Z/2612 _ Reinspection Date:
Fee Paid: Vz`i of ChkNo: `10(;5i1 C
Application Complete:
P lic Works Signature/Date
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.