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CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
CERTIFICATION FOR DEMO PERMITS
PROPERTY ADDRESS:
DEMO PERMIT NUMBER:
PERMITTEE NAME:
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PERMITTEE PHONE:
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OWNER NAME:
PHONE NUMBER:
OWNER'S INTERIM MAILING
ADDRESS:
Please list street
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city, state and zip code.
in the space provided
❑I hereby certify that I will not remove, root prune, or trim any trees
located in the street parkway or public right-of-way. I understand that
I and/or the property owner will be liable for all costs and substantial
penalties if any parkway tree or public property (i.e. sidewalk, curb,
gutter, and/or street) is damaged or removed during the demolition
process.
❑A "Temporary Street Closure Permit" must be obtained from the
Public Works Department if a dumpster or building material is placed
in the public right-of-way.
DATE SIGNATURE
PRINTED NAME
I
FiUserstPBWlBhared\l-ENCROACH\Demo Permit.0.e olition Permit-Certifimtion.doc