City of San Diego E-Permits

City of San Diego E-Permits

Application Form

1. Applicant Information
Applicant Name
Applicant Address
Applicant City
Applicant State
Applicant Zip Code
Applicant Telephone	(xxx)-(xxxxxxx)
Applicant Email	(Please ensure accuracy, if incorrect your permit will not be processed.)

Please check one

Contractor

Property Owner

If you are a Contractor or a Property Owner using a Contractor please fill out this information:

2. Contractor Information
Contractor Name
Address
City
State
Zip Code
Telephone	(xxx)-(xxxxxxx)
State License No.
License Class
City Business Tax No.

2A. Licensed Contractor's Declaration: I hereby affirm that I am licensed under provision of Chapter 9 (commencing with Section 700) of Division 3 of the Business and Professions Code, and my license is in full force and effect.

In Lieu of Signature,
Check Here
Title	Owner Agent
Date	08/07/2008

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