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Revised 7/10/2025 BUILDING PERMIT EXTENSION REQUEST FORM Phone: [PHONE REDACTED] / Email: [EMAIL REDACTED] Building Permits are valid as long as there is continued progress on the project. If there is a delay or stop in the work for 180 days or more, an extension should then be requested or the Building Permit may be cancelled, requiring the applicant to reapply PERMIT INFORMATION Permit # Permit Type: Commercial Residential Project Address: Has the original scope of work changed? Yes (provide below) No PROVIDE A CURRENT PROJECT TIMELINE: APPLICANT/ REQUESTOR INFORMATION Owner Contractor Other: NAME: PHONE NUMBER: EMAIL ADDRESS: Has the owner or contractor information changed? Yes (provide below) No ---PAGE BREAK--- Revised 7/10/2025 If an extension is granted, you must notify the Building Department of any changes to your project, including the timeline. If you are unable to meet the approved extension date, you must contact the Building Department prior to your extension expiration. Send this completed form and any questions to [EMAIL REDACTED]. EXTENSION JUSTIFICATION (Please explain your reason for requesting an extension) Applicant/ Requestor Signature Date OFFICE USE APPROVED to DENIED Building Official Signature Date By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.