Fillable Borough of Wilkinsburg Code Enforcement (Borough of Wilkinsburg)

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Borough of Wilkinsburg Code Enforcement (Borough of Wilkinsburg)

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BROWSE BOROUGH OF WILKINSBURG (PA) FORMS

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Modified 3/29/2017
Borough of Wilkinsburg
Code Enforcement
Municipal Building
605 Ross Avenue
Wilkinsburg, PA 15221
Phone: (412) 244-2923 Fax: (412) 244-2922
OCCUPANCY PERMIT APPLICATION FORM
In accordance with Chapter 188 of Borough Code of Ordinances
TYPE OF REGISTRATION: CHANGE OF TENANT CHANGE OF OWNERSHIP
Usage: Commercial Residential: Single Family Duplex
(Note: Each unit in a multi-dwelling building needs their own individual permit and application)
Property Address _____________________________________________ Unit # ____________________
Parcel Number or Lot & Block ___________________________ Total Number of Units ______________
Property Owner Name___________________________________________________________________
Owner’s Address____________________________ City _________________State_____ Zip___________
Phone Mobile Fax
E-mail Address________________________________________________________
Emergency/Realtor/Property Manager Contact (over 6 units required) _____________________________
Emergency/Property Manager Address ________________________ City __________State____ Zip_____
Phone-Work Mobile ___________________ Fax ______________________
E-mail Address________________________________________________________
Prospective Tenant Name ____________________________ Phone Number ______________________
Current Address_________________________________City________________State_____Zip_______
E-mail Address ____________________________________ Number of Occupants__________________
Fee (per unit) $60.00
Please print clearly. Illegible and incomplete forms will not be accepted. Please remit payment with this
application. For Corporations, a form of identification of an authorized officer of the company, or copy of
a written agreement of the corporation’s registered agent is required.
Applicant Signature
Print Name: ___________________________________________
Signature: ____________________________________________ Date: ______________
For Office Use Only
Permit Number ______________________ Fee Paid $ ______________
Approved By: __________________________________________ Date: _____________
Title: _________________________________________________
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Borough of Wilkinsburg Code Enforcement (Borough of Wilkinsburg)

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Completed 17 July 2020

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