HomeMy WebLinkAbout22-3-14 Signed app & pymtDocuSign Envelope ID: 7C5FFA47-B3BC-4DC2-9D80-F42BFEF09151
HARBOR PERMIT
TRANSFER APPLICATION
100 Civic Center ]Drive
Newport Beach, CA 92660
949-694-3044
**Date of Application:
**Property Address:
**Buyer's Names: Ske e ere6 pa -QC" ScWY-,V -z
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Buyers Signatures: a�-
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Billing Address: 2255- Co.+bon Mesa rya, Mak�bu CNc q'DGS'
Telephone No.: ao,5P 3(�- of(
'Seller's Names: k) -'ls SS av�a )hvia, 11�nu�s
Seller's Signatures:
Joint Owner Signature:
**Escrow Company:Efcroc�s Phone#�i-1�-& 1`-1-3934
**Address 12oc) t k pox- cc-*-r D-, k�-
**Escrow Number: OSSt�h-A tw
**Closing Date (Estimate): 02IasJ22 **Email: �iJ��s �� ,eScrow_co n
**STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date: a{►s�aa Reinspection Date:
Fee Paid:'.,� Check No: 533( )
Application Complete:
Public Workd Signature/Date
Special Conditions: This permit is revocable by the City Council
in accordance with Title 17 of the Newport Beach Municipal Code.
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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
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Yes,, Need None Needed
Reinspection
Yes Need