FORM NO. BI 39 REV. 08/19
Application for Commercial New/Addition/Alteration Permit
CITY OF VIRGINIA BEACH ∙ PERMITS AND INSPECTIONS
2875 Sabre St, Suite 500 ∙ Virginia Beach, VA 23452 ∙ (757) 385-8060
FAX (757) 385-5777 ∙ www.vbgov.com/buildingpermits
Date
A permit is hereby requested for the following construction at:
Street Address: Lot #/Suite #:
GPIN:
Owner/Occupant Name: Owner Phone #:
Email Address: Cell Phone #:
Mechanic’s Lien Agent Name: None Designated
Address: Phone #:
Email Address: Cell Phone #:
Contractor:
Company Name: State Registration #:
Check Scope of Work: New Addition Alteration
Total cost of construction/alteration: $
# of Bedrooms # of Bathrooms
Public Utilities Receipt #: HRSD Receipt #: EIFS: Yes No
Construction Type: 1A 1B 2A 2B 3A 3B 4 5A 5B
Use Groups: A1 A2 A3 A4 A5 B E F1 F2 H1 H2 H3
H4 I1 I2 I3 M R1 R2 R3 S1 S2 U
Scope of Work:
Use Group Const. Type Description Square Footage Value
Additional Information:
Applicant’s Name (Please Print): Applicant’s Signature:
I understand this permit is granted only for the work shown and described in this application.
Any falsification, misrepresentation, or misleading information given VOIDS this permit.
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