Pittsburgh, PA · Allegheny County
Request for Revocation of Permit
Property owners, their representatives, permit holders, or their representatives use this Pittsburgh form to ask the Department of Permits, Licenses & Inspections to revoke a permit.
What this form is
This form lets an owner or permit holder, or their representative, request revocation of a Pittsburgh permit. It asks for contact information, the jobsite address, lot and block, ward, permit number, the requester’s role, and the reason for the request. Submission does not guarantee revocation: the department says it will inspect and decide whether revocation is appropriate, and a new permit may be needed to complete work.
Who needs it
A property owner or permit holder, or their representative, who wants the Department of Permits, Licenses & Inspections to consider revoking a permit needs this form.
How to submit it
The form lists the Department of Permits, Licenses & Inspections at 200 Ross Street, Civic Building, Third Floor, and phone 412-255-2175; it does not state a submission method.
About notarization
This request is signed and dated without a notary; the signer attests to being the owner or permit holder, or their representative.
How to submit this form
- 1
Download The Form
Download the Request for Revocation of Permit PDF.
- 2
Complete The Request
Enter your contact details, permit and jobsite information, role, and reason for requesting revocation.
- 3
Sign And Date
Sign and date the form to attest that you are the owner or permit holder, or their representative.
- 4
Contact The Department
The form lists the Department of Permits, Licenses & Inspections at 200 Ross Street, Civic Building, Third Floor; it does not specify a submission method.
Frequently asked questions
- Do I need a notary for the Request for Revocation of Permit?
- No. The form is signed and dated without a notary; the signer attests to being the owner or permit holder, or their representative.
- How do I submit the Request for Revocation of Permit?
- The form lists the Department of Permits, Licenses & Inspections at 200 Ross Street, Civic Building, Third Floor, and phone 412-255-2175, but does not specify how to submit it.
- Does submitting the request guarantee that a permit will be revoked?
- No. The form says the department must inspect to assess safety and appropriateness, then determine whether revocation is appropriate.
- What information does the form ask for?
- It asks for the requester’s contact information and role, the jobsite address, lot and block, ward, permit number, and reason for the request.
Need something notarized?
This Request for Revocation of Permit doesn’t need a notary — but if you have another Pittsburgh form that does, a commissioned online notary can help.