85244-4008
Development Services Department
Building Safety Division
215 E. Buffalo St., Chandler, AZ 85225
Telephone: 480- 782-
chandleraz.gov
Form No: UDM-
Rev:1-15-
Petition of
to the Building
This document is used to request a modification of the Chandler Building Code under section 104.10; approval of
alternate materials, design, and/or methods of construction under section 104.11; an interpretation under section
104.1; or for a code provision specifically requiring Building Official approval such as the exception to section 1004.1.2. A
$180.00 fee is charged per appeal.
Date: __________________
Project Name (Please type or print)
Owner or Owner’s representative
Applicant’s Name (not company name)
E-mail Address (required)
Relationship of applicant to project
Staff member familiar with project
Appeal is hereby made to the Building Official for approval of a modification; alternate; interpretation; or exception
pertaining to:
Section__________________________________ of the ____________________________________Code, as adopted by the City of Chandler,
which requires:
This Code requirement presents practical difficulties to this project because (use attachment if necessary):
I request acceptance of (use attachment if necessary):
I believe this proposal meets the intent of the Code because:
If the applicant is not the owner or the owner’s architect or
engineer, then the owner must sign here
Applicant’s signature and title
Additional information such as floor plans and/or product specifications may be required.
