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DS-4102(02-18)
FORM
DS-4102
City of San Diego
Development Services
1222 First Avenue, MS. 401
San Diego, CA 92101
Attn: Application Extension
Building Permit
Application Extension
September 2018
This form shall be completed to request an extension of time for a Building Permit Application. If a permit has not
been obtained within one year from the permit application date, the application will expire. Land Development Code
Section 129.0211 authorizes the Building Ocial to extend a Building Permit application one time for a period not
exceeding 180 calendar days from the expiration date, if the Building Ocial determines that circumstances beyond
the control of the applicant prevented issuance of the Building Permit.
Complete the information below for all Permit Application Extension requests. Please e-mail form
to: DSDApplicationExtend@sandiego.gov or by postal mail to the address above. A non-refundable
processing fee is assessed for all requests. See Information Bulletin 501 for fee listing.
For any questions regarding your application extension, email to the email address shown on this form.
Please print or type legibly. A separate extension application form is required for each building permit application.
Make sure to include the Project number in the subject line of the email.
I. GENERAL PROJECT INFORMATION
Is there an active code enforcement violation case on this site?
Yes No
Project Number:
Project Address/Location:
Reason for Application Extension Request:
II. APPLICANT’S INFORMATION
Applicant’s Name (The name must be in the City’s Project Tracking System)
Check one Property Owner Permit Holder
Address: City: State:
Email: Telephone: Date:
