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2. 
3. Board of Building Appeals Request Form
5. Any person having record title or legal interest in the building may appeal from any notice of violation or notice and order or any action of the Building Official under this title by filing at the office of the Building Official within thirty (30) calendar days from the date of service of the notice of violation or notice and order, or the date of the action of the Building Official, a written appeal. (a)The written appeal must contain a brief statement setting forth the legal interest of each of the appellants in the buildi ng or the land subject to the action of the Building Official or involved in the notice of violation or notice and order. The written appeal must contain a brief statement in ordinary and concise language of the specific order, action and or Building Code section under protest, together with any material facts that support the contentions of the appellant. (b)The written appeal must contain a brief statement in ordinary and concise language of the relief sought, and the reasons why it is claimed, why the protested order or action should be reversed, modified, or otherwise set aside. (c)The written appeal must contain signatures of all parties named as appellants and their official mailing addresses. (d)At least one (1) appellant must submit a declaration under penalty of perjury as to the truth of matters stated in the app eal. This declaration must be submitted with the written appeal itself
7. Appellant's First Name*
8. Appellant's Last Name*
9. Appellant's Email Address*
11. Appellant's Street Address*
13. Appellant's City*
14. Appellant's State*
    -- Select One --AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
15. Appellant's Zip Code*
17. Building/Property Street Address*
19. The participants listed above declare that they have a legal interest in the building or land involved in the order issued by the Chief Building Official. This interest is:
21. Building Official's Specific order or action protested:
23. Reasons why the protested order or action should be reversed, modified, or otherwise set aside:
25. I declare under penalty of perjury that the information stated in the appeal above is true and correct.

    1. YES
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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