GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS 
DEPARTMENT OF PLANNING AND NATURAL RESOURCES 
DIVISION OF PERMITS 
STX DISTRICT TEL: (340) 773-1082  STT/STJ DISTRICT TEL: (340) 774-3320 
APPLICATION for BUILDING PERMIT 
Applied for Under: The USVI Building Codes 
Parcel Identification Number (PIN)  
Owner of the building:  
      Owner’s phone number:__________________ Owner’s email: ___________________________ 
Owner’s mailing address:  
Lessee information:  
Location of Work 
Plot No.  
Estate 
Quarter 
Zone 
House No. 
Street 
Flood Zone 
General statement of the proposed work: 
________________________________________________________________________________________________ 
______________________________________________________________________________________________ 
______________________________________________________________________________________________ 
______________________________________________________________________________________________ 
Description of the proposed work and information related thereto: 
1.
Occupancy: No. of Units:
No. of stories:  
2.
Floor area:
sq. ft. (exterior dimension) 
Total Structure 
sq. ft. 
3.
Type of exterior walls:
Building Height 
4.
Type of roof:
5.
Roof area used for catchment:
6.
Cistern    ☐ New  ☐ Existing
7.
Cistern interior dimensions:
ft. long x 
ft. wide x 
ft. (high to overflow) x 7.5 
gallons. 
8.
No. of bedrooms:
9.
No. of bathrooms:
10. Total no. of other rooms:
11. No. of plumbing fixtures:
12. Total no. of rooms with electrical service
13. Will the proposed work encroach on public rights-of-way or on the property of others: ☐ Yes  ☐ No
14. Total estimated cost of the proposed work: $
_______________________________________   
15. Has work been started? ☐ Yes ☐ No
16. The contractor who will perform the work. ______________________________ License No. ________________
Signature of owner:  
  Date Signed: ___________________________
Class of Work 
☐New
☐Alteration
☐Addition 
☐ Repair
Use of Building 
☐Residential ☐Commercial
Group Occupancy 
Classification:  
☐Other