Atherton, CA · San Mateo County
Permit Cancellation and Request for Refund
This form lets the original permittee request cancellation of a building permit or application and a refund of eligible fees from the Town of Atherton.
What this form is
The form authorizes cancellation of a building permit or application and requests a refund of fees allowed under the stated refund rules. The original permittee must file a written request within 180 days of fee payment; refunds may depend on whether plan review or permitted work has begun. The form asks for the project address, permit number, cancellation reason, contact details, signature, and date.
Who needs it
The original permittee who wants to cancel a building permit or application and request a refund of eligible fees should complete this form.
How to submit it
File a written request with the Town of Atherton Permit Center, 93 Station Lane, Atherton, CA 94027, within 180 days of fee payment; call 650-752-0560.
About notarization
This document is signed and dated without a notary; the form does not mention a sworn statement or notarized attachment.
How to submit this form
- 1
Download The Form
Download the Permit Cancellation and Request for Refund form.
- 2
Complete The Required Fields
Enter the project address, building permit number, cancellation reason, contact information, and the required signature and date.
- 3
Gather Any Supporting Letter
If you want the refund check payable to someone other than the applicant listed on the permit who paid the fees, include that applicant’s approval letter.
- 4
Submit To The Permit Center
File the written request with the Town of Atherton Permit Center within 180 days of fee payment.
Frequently asked questions
- Who can request a permit cancellation and refund?
- The form is for the original permittee. It asks the permittee to identify the project and permit, give a reason for cancellation, provide contact information, and sign and date the request.
- Do I need a notary for the Permit Cancellation and Request for Refund?
- No. The form requires a signature and date, but does not require notarization. It also does not mention a sworn statement or notarized attachment.
- How do I submit the permit cancellation and refund request?
- File the written request with the Town of Atherton Permit Center, 93 Station Lane, Atherton, CA 94027. The form lists 650-752-0560 and says the request must be filed within 180 days of fee payment.