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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 ���5 i-�cz�'2c;�. Telephone S3( G'=4',��
Company �l���tr,v�r ��=�5' _ Fax �3 � 6 - �l/
Address � 2�c� L%ML-i�/-�-L s�. Email C'� �-S c�'�/U2T/�cvi�"S�G✓s'-��'�
City, State & Zip S�ti�a- c�wZ �`s'o6�
1 certify under penalty of perjury that the information given herein is true and correcf the best of my knowledge and
belief. 1 understand that a building permit is required before a sign can be installed.
Applicant Signatur �'� - '�� Date � /$�/
2. PROPERTY OWNER
Name , c�grs'�1� ,��%�-4� Telephone GSa�3�,�- �S�G
Address / �IS � L�f-n-�z�- �'�- Fax
City, State & Zip 3�rZ������ � Email
1 know about the proposed sign(s) and authorize the applicant to submif this application.
Property Owner Signature �� �i-rT��'� Date ��f���i
3. SITE ADDRESS I�/g �L-��My�- �Z Assessor's Parcel Number �Z°I- Z33 - O�D
Lot Width 5�13 •e �� Building Width
Lot Depth I� 2• d?' Building Depth
4. SIGN INFORMATION (please attach photos)
# of Existing Signs On Property: '2- Proposed New Signs: �
# of Existing Signs To Remain: 2 Total # of Signs: 3
......................................................................................
.............................................
----------------------------TO BE COMPLETED BY PLANNING STAFF--------------------------------
Maximum Sign Existing Sign Area/ New Signs - Total Site Signage
Area/ # Of Signs # of Signs to Area/# of Signs with this
Allowed: Remain Application
Wall & Projecting Signs
Building Frontage #1: /
Building Frontage #2: /
Freestanding Signs
Parcel Frontage #1 So� Si c�¢. 3
/
Parcel Frontage #2 / �
/
/
4 ` � �e % s iid,�.
❑ Sign exception required
,� Building permit may be approved.
Approved by: � �� �. �..�. � � Date
,� Fee to be collected by Building Dept. ���• � O
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�' Remember! A building permit must be issued before the sign can be installed.
!! over for page 2
S:IHANDOUTSISIGN PERMIT app + documentslSIGN.PERMIT.application.October 2008.doc Revised October 2008
SIGN A: 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 6 = � � �� X Height � � )
Sign area $ Z Square Feet 4.� SF �c✓� S►' cic.>
�
Overall height from ground �
Clearance from ground to sign bottom
Single face �_ Two-sided
Copy l�rz��-�.i�� � S�n-�.�-�-�
Method of support ;�D/�f Illumination type L��PS Hours
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 X Height )
Sign area Square Feet
Copy
Method of support
Overall height from ground
Clearance from ground to sign bottom
Single face Two-sided
Illumination type
Hours
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
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
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 X Height )
Sign area Square Feet
Copy
Method of support
Overall height from ground
Clearance from ground to sign bottom
Single face Two-sided
Illumination type
Hours
S:IHANDOUTSIS/GN PERMIT app + documentslSIGN.PERMIT.application.October 2008.doc Revised October 2008
Lease No: 33225
Dealer ld: 9305
D�v/Dlr No: Chevrolet/6004
CONSENT AND AGREEMENT OF LAND OWNER
(If Dealersh�p does not own the land)
Page 2 of 9
The undersigned, who is the owner of the land described in the attached Dealership Identification Lease
Agreement between GM-DI LEASING CORPORATION, as Lessor, and PUTNAM CHEVROLET CADILLAC,
as Lessee, hereby consents to the installation. maintenance, operation and removal of the sign(s) to be installed
pursuant to said Lease.
The undersigned further acknowledges that the aforesaid sign(s) are the property of GM-DI LEASING
CORPORATION and agrees that, in the event of termination or expiration of said Lease or any extension or
renewal thereof, GM-DI LEASING CORPORATION may at any time thereafter enter upon and remove from the
premises all of the sign(s) installed pursuant to said Lease. It is further acknowledged by the undersigned that
Lessor's only obligations upon any such removal of sign(s) shall be tllose described in the attached Lease and
General Provisions.
IN WITNESS WHEREOF, the Owner, on behalf of �tself and its successors and ass�gns, has signed and sealed this instrument
this �,� day of . 20 � �-i , • /� l�u��7�i,,,
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�i � iNamc of Lnnlyd wnerC�� Indiv' 1� �1'�' `,� .��1L
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In the presence of: tTwo inesses►
_ _ � � � -- —
( itn�ss 1) —
�_,_.__ _. _ _ - . ----
( Witncss 2)
STATE OF � �¢�
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COUNTY OF
BY � �-e,�,,,,iT�tle �yl.�. �"'/� �/ /
� (A�d �ignnturel / i��
NAME -- �� 1.���_��� --- -
(Please Pnnt or Type)
ADDRESS:
TELEPHONE N(�.
The foregoing instrument was acknowledged before me th�s �� day of �i�. AD. �� (
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My Commiss�on Exp'ues: __T `� Z'� ��
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