FORM NO. BI 72 REV. 08/19
Application for Residential New/Addition/Alteration Permit
CITY OF VIRGINIA BEACH ∙ PERMITS AND INSPECTIONS
2875 Sabre Street, 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
Model # # of Floors
Total cost of construction/alteration: $
# of Bedrooms # of Bathrooms
Public Utilities Receipt #: __ __ HRSD Receipt #: ____ EIFS (Yes/No): __________
For New Structures Total the Sq. Footage: _______________
Ad
ditional 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.
Sq. Footage
Value
Carport
Deck
Duplex
Farm Building
Garage
Gazebo
Greenhouse
Heated Pool House
Moved Residence
Non-heated Pool House
Sq. Footage
Value
Patio
Porch
Room over Garage-heated
Room over Garage-heated
Screened Porch
Single Family
Storage/Shed
Sunroom
Townhouse
Value
Above Ground Pool
Boat Lift/Pier
Bulkhead/Rip Rap
Driveway
Hot Tub
In-ground Pool
Mobile Home
Pool Fence
Value
Tennis Court
Tent
UST/AST New/Alteration
No
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