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.<br><br>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.

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

4. Permit Number*

5. Escrow Refund Amount*

7. Project Site Street Address*

9. As-built submitted to City?*

   1. Yes

   1. No

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

12. Contractor Company Name*

14. Contractor Mailing Address*

16. City*

17. State*

18. Zip Code*

20. Contact Name for Questions*

22. Contact Email*

23. Contact Phone*

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field