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COMMUNITY DEVELOPMENT DEPARTMENT • 501 PRIMROSE ROAD • BURLINGAME, CA 94010
p: 650.558.7250 • f: 650.696.3790 • www.burlingame.org
Sign Permit Application
1. APPLICANT (person completing this form)
Name �2n% Pv�t hatnn Telephone ��8 �Go2
Company {�aw� �4� �r�.�,o lue Fax ��t (�f
Address 3 C�c li` � n r'a t7� � Email �{- 4� u�'o•co�n
City, State & Zip 8� r i k�w� e G W 4Ko�o
I certify under penalty of perjury that the information given herein is true and correct the best of my knowledge and
belief. I understand that a building permit is required before a sign can be insfalled.
Applicant Signature �?�T �,cG��� Date ZG �/
2. PROPERTY OWNER
Name � P��o-�tn Telephone ��� �gU�
Address 3 Ca l� i�c�,u 11� - Fax 3�7 /�f 5 d
City, State & Zip D� f(` C� !O Email �(-�,�Nd.w�c�'b• cuu�
I know abouf the proposed sign(s) a d aut�hm�i�e the applicant to submit this application.
Property Owner Signature � � Date
3. SITE ADDRESS ��� ��� �d� K�tv � t(�'. Assessor's Parcel Number �
Lot Width �' 27 Building Width b Z�t � 2y z' Z��
Lot Depth �� 23 Building Depth �ZO
4. SIGN INFORMATION (please attach photos) �
# of Existing Signs On Property: 2 Proposed New Signs:
# of Existing Signs To Remain: / Total # of Signs: �
----------------------------TO B E C O M P L ET E D BY P LAN N I N G STAF F-----------
Maximum Sign Existing Sign Area/ New Signs —
Area/ # Of Signs # of Signs to Area/# of Signs
Allowed: Remain
�LL 11 D Or�ie�fir�iv C:•�••••+ _
Tct�r+�rr
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Freesfanding Signs �PoU+. s� �''`� �
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Parcel Frontage #1 3 ov �� ����' ti1 //}- � D I•'� � s�
Parcel Frontage #2 / / /
❑ Sign exception required
�—$uilding permit may be
Approved by:
`� Fee to be col
by Building Dept. �J • �
Total Site Signage
with this
Application
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lol•`� / �. sr�d
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Date: 0� 9 y � 0
`� Remember! A building permit must be issued before the sign can be installed.
!! over for page 2
S:IHANDOUTSISIGN PERMIT app + documentslSIGN.PERMlT.application.October 2008.doc Revised October 2008
SIGN A: New Sign Existing, no change Existing, new copy
Sign Type:
❑
❑
❑
G�'
❑
❑
❑
Window Sign
Wall Sign
Ground Sign
Pole Sign
Projecting Sign
Awning Sign
Other
Sign Specifications: �
(Length ��- Z�� X Height 2 l� )
Sign area o. � Square Feet
Overall height from ground
Clearance from ground to sign bottom
Single face - Two-sided
Copy
Method of support
Illumination type
SIGN B: New Sign Existing, no change Existing, new copy
Sign Type:
❑
❑
❑
❑
❑
❑
❑
Window Sign
Wall Sign
Ground Sign
Pole Sign
Projecting Sign
Awning Sign
Other
Sign Specifications:
(Length
Sign area
X Height )
_ Square Feet
Copy
Method of support
Overall height from ground
Clearance from ground to sign bottom
Single face Two-sided
Illumination type
SIGN C: New Sign Existing, no change Existing, new copy
Sign Type:
■
■
■
■
■
■
�■
Window Sign
Wall Sign
Ground Sign
Pole Sign
Projecting Sign
Awning Sign
Other
Copy
Method of support
Sign Specifications:
(Length
Sign area
Hours
Hours
X Height )
_ Square Feet
Overall height from ground
Clearance from ground to sign bottom
Single face Two-sided
Illumination type
Hours
SIGN D: New Sign Existing, no change Existing, new copy
Sign Type:
❑
❑
❑
❑
❑
❑
�
Window Sign
Wall Sign
Ground Sign
Pole Sign
Projecting Sign
Awning Sign
Other
Sign Specifications:
(Length
Sign area
X Height )
_ Square Feet
Copy
Method of support
Overall height from ground
Clearance from ground to sign bottom
Single face Two-sided
Illumination type
Hours
S:IHANDOUTSISIGN PERMIT app + documentslSIGN.PERMIT.application.October 2008.doc Revised October 2008
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