The streetname plus house number plus an optional letter plus an optional floor and side/number, plus postal code and town/city/district makes sense in a lot of the western world, but can break down very badly when trying to handle international addresses.
Take down the phone number and email address in separate fields, their formats are at least reasonably constrained.
For name and address, put a text box, and let people add as their name and address in the format that makes sense to them. If you need to send them anything physical, the various postal services around the world are really good at figuring out the right destinations for letters and packages.