Building Permit Exemption Application (addendum)

Addendum to Building Permit Act # 44 of 1993

MUNICIPALITY OF PENN HILLS
CODE ENFORCEMENT DEPARTMENT
12245 FRANKSTOWN ROAD
PENN HILLS , PA 15235
OFFICE # (412)798-2132 / FAX # (412)798-2160

If an exemption is being claimed, please complete the following and sign in the presence of a notary public

Basis for exemption (required)
check one

Explain

Name of Applicant (required)

Email (required)

Address (required)

City (required)

State (required)

Zip Code (required)

Phone No. (required)

Signature (required)