HomeMy WebLinkAbout20-11-17 Signed Pier trnsfrm
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center Udve
Newport Beach, CA 92660
949-bQ9-.3044
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Jeremy David Tiss and Stephanie Hsui-Jen Tin, Trustees
*Buyer's Names:: of the Jeremy and Stephanie Tiss Family Trust UTA, Dated 12/31/18
Buyer's Signatures
Billing Address: P.O. Box 11762, Newport Beach CA-92658
nhnnp tan v) (949) 292-4669
'Saffer`s Names -
Seller's Signature .
Joint Owner Signature
Freedom Escrow
949-644-3939
rt Beach
I..,jusaaLI umt: tc5uruu e). 7 1.13 / „ t:ntau uw� rreeoomescrow. com
*STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Gate, li 9-0 Relnspeciton Date.
Fee Paid:- 0 r\9 check NO:-.) del
SPOOMI Coal WWS ThisPezW is revocablb by the City Councy
in €acm(dOnco moth Title 17 of the N%Vporl Beech Municipal Code �
INSPECTION FORM
Public Works
Date:
Inspection Requested By:
Inspector: /�%i
Pier Address: C;to ea &f—&-`td`
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Pier Transfer
GFI Present
Anti -Siphon / Backflow Present
Other Comments
Comments / Observations
Other Request
Reinspection
Yes Need None Needed Yes Need
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