Building Permit: New Home Escrow Refund Request

2. Instructions
   Please fill out this form to request a building permit escrow release. Fill out one form for each address being requested.

   Please fill out this form to request a building permit escrow release. Fill out one form for each address being requested.

4. For a new construction permit, do not submit a request for escrow refund until as-built survey is approved, final inspection complete and certificate of occupancy is issued.

   For a new construction permit, do not submit a request for escrow refund until as-built survey is approved, final inspection complete and certificate of occupancy is issued.

6. Permit Number*

7. Escrow Refund Amount*

9. Project Site Street Address*

11. As-built submitted to City?*

    1. Yes

    1. No

12. Final Certificate of Occupancy Issuance Date*
    Final Certificate of Occupancy Issuance Date

14. Contractor Company Name*

16. Contractor Mailing Address*

18. City*

19. State*

20. Zip Code*

22. Contact Name for Questions*

24. Contact Email*

25. Contact Phone*

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field