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 
 INSPECTION REQUEST FORM 
Date: ___________________   REQUESTED BY: ___________________________    PHONE: __________________________ 
(Please Print Clearly) 
NAME OF OWNER:  ______________________________________________________________________________________ 
LOCATION OF BUILDING: ________________________________________________________________________________ 
BUILDING PERMIT NO.: ______________________  BUILDER: ________________________________________________ 
ELECTRICAL PERMIT NO.: ___________________  ELECTRICIAN:  ___________________________________________ 
PLUMBING PERMIT NO.: _____________________  PLUMBER: _______________________________________________ 
   PLEASE GIVE EXPLICIT WRITTEN AND/OR GRAPHIC DIRECTIONS TO THE PROPERTY 
________________________________________________________________________________________________________ 
________________________________________________________________________________________________________
________________________________________________________________________________________________________
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BUILDING 
ELECTRICAL 
PLUMBING 
FLOOD 
☐Footings/Cistern Bottom
☐Floor Slab
☐Floor Slab
☐Floor Slab
☐Foundation/Footings/Floor
Slab
☐Rough-in (Walls)
☐Rough-in (Walls)
☐Certificate of Elevation
☐Temporary Power
☐Main Distribution
Line/Sewage System
☐Walls
☐Columns
☐Beams
☐ Ground Mount Solar 
☐Mechanical
☐ Roof 
☐Re-inspection
☐Re-inspection
☐Re-inspection
☐Other
______________________
☐Other
__________________
☐Other
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NOTE: Pursuant to Title 29 Chapter 5 § 294 (b) of the VI code, an approved set of plans should be readily available to 
Inspectors and the permit shall be prominently displayed at the site of work. 
***Work shall not be done beyond the point indicated above inspection request without obtaining approval to proceed to 
the next phase. *** 
Seal and Signature of USVI 
Licensed Electrician or Plumber