DRB96019
DRB 96019
423 Cleveland St
Tsafatinos
CENTRAL PERMITTING
100 SOUTH MYRTLE AVENUE
P.O. BOX 4748
CLEARWATER, FLORIDA
(813) 562-4567
SIGN PERMIT APPLICATION
."
PLANS AND SPECIFICATIONS FOR ANY PROPOSED SIGN SHALL BE SUBMI1TED IN DUPLICATE. DRAWN TO SCALE AND INCLUDE THE !E
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(a) Site Plan.
(b) Dimensions and elevations (Including the message) of the sign
(c) Lot frontage on all street rights-of-way
(d) Maximum and minimum height of the sign. as measured from finished grade
(e) Location of the sign In relation to property lines. public rights-of-way. easements. buildings, and other signs on the property
(Pole signs must be a minimum of 5 feet from property line )
(1) Dimensions of the sign's supporting members.
(g) For illuminated signs. the type. placement . intensity and hours of U1umlnatlon (Not more than five (5) footcandles of light
Intensity for commercial signs )
(h) Construction and electrical specifications. for the purpose of enabling determination that the sign meets all applicable
structural and electrical requirements of the Building and National Electric Codes (Indicate If UL rated )
(i) Inventory of all exlstlna slans on the same property and/or building on which the sign is to be located . Indicating the number.
type. use e.g, property identlflcatlon. business identification. etc) location and surface area. (If -none: so indicate)
· All applications for signs shall Include detail drawings showing how the sign Is to be constructed and secured All signs greater
than 32 square feet In size shall have structural drawing signed and sealed by licensed Florida engineer or architect
ALS.Q. please note that wind load requirements should conform to the 1991 edition of the Southem Standard Building Code
SUBDIVISION
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PROJECT ADDRESS
Y;J 3 e/2u-e {tAMd );1--
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LOT
BLOCK/TRACT
PARCEL NUMBER / I
OWNER --;;if' (' I );A ~ GL )., Al 0 s
ADDRESS 0 4, 1 S,AJ u~ I S" L- ~;J ()
LESSEE (OF PROPERTY OR BUILDING) /Y) ekd r <l L ! ,
BUSINESS NAME ~ r...aJSSAr0 c Q 11-~ Qe ~u.:t.:j
ADDRESS 'I~3 C~l>e~ \' f-
C11Y/STATE/ZIPCODE ~L-.S>._~, OZL
DESIGN REQUIRED 0 DISTRICT
REVIEW NOT-APPLICABLE 0
BOARD
/
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TELEPHON~ fO) 9' Y 1- .J b b 0
t!C2O--r~ STATE rP..- ZIP ?V6 ] ()
C11Y
E AYT/::;Yf'. PR .J:-e "
,
1;\1 c.
-5 '1~! _\
URBAN CENTER 0
CLRWTR. BEACH 0
N GREENWOOD 0
TELEPHONe( '('I ~ ') 1/1.( ( ~ 3"$ 9 ?
STATUS DATE
APPROVED 0
DENIED 0
TELEPHONE
CONTRACTOR
/J 1ft
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ADDRESS
C11Y
STATE
ZIP
STATE NO,
CLEARWATER LICENSE NO
TYPE OF SIGN. _ POLE - PROJECTING
L WAll _ GROUND
SURFACE AREA IN SQ FT (<J!if VALUE OF SIGN
_ WINDOW _ CANOPY. AWNING OR MARQUEE
_ PORTABLE _ OTHER
00
000 -
..1. ELECTRICAL PERMIT NEEDED?
1\ ID
_~ _ ~~_. ~_ . _ _ & __ L.'--' .... _. IP'" _~I ~.. ...,... ..r-...... AI ........a...,.... I t('i 'n r."IfI'TI..^~r'\ n~"An\I^1 r-r'\~
Statement of Authorization - Any application form which Is signed by an Individual other than the property owner sholl be
accompanied by a notartzed statement of authorization consenting to the slgn placement or, If the property or buildIng upon
which the sign Is to be located Is leased. a copy of the executed lease shall accompany the application form In the event the
building or property Is leased and the application form Is signed by an IndIvidual other than tAe lessor. the appllcatlon sholl be
accompanied by a notarized statement of authorlzal1on signed by the lessor consenl1ng to the sign placement and a copy of
the executed lease (Not required for portable signs/face changes or signs approved by variances,)
CERTIFICATION
I certify that all information submitted on this application and attachments thereto are true and correct to the best of my
knowledge and belief I understand that any Inoccurate Information may result In revocation of the sign permit and removal
of ony sign erected pursuant to such permit I will be responsible for the Installation of the subject sign In accordance with the
sign regulations of the City of Clearwater
I acknowledge that all nonconforming signs are subject to the amortization provisions contained In Section 44 55 of the City of
Oaarwater Code of Ordinances and must be brought into compliance before October 13, 1992 Furthermore, I understand that
any Investment made In or to a nonconforming sign during the amort1zation period, Including but not limited to message
changes, sholl not constitute grounds for noncompllance or compliance later than October 13. , 992.
Print Property Owner (or representative) Name
Property Owner's Signature (or authorized representahve)
(FOR OFFICE USE ONLY)
AtiasPage
Zoning
51googe Permitted
Zoning Approval
Date
Traffic Eng Approval
Building Approval
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