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City of Puyallup Application for Sign Permit Building Division 333 S. Meridian Puyallup, WA 98371 Tel: (253) 864-4165 Fax: (253) 840-6678 Site & Sign Information: Is This a Corner Lot? Yes ☐ No ☐ Lineal Measurement of Street Frontage Lineal Measurement of Side Street Frontage (if applicable) Zoning Lineal Measurement of Wall From Which Sign is Attached Lineal Measurement of Canopy From Which Sign is Attached East Façade West Façade North Façade South Façade Sign Type ☐ Monument ☐ Facade / Wall ☐ Freestanding / Pole ☐ Electronic Message ☐ Other: ☐ Externally Lit ☐ Internally Lit ☐ Under Canopy (SUBMIT A SEPARATE APPLICATION FOR EACH SIGN TYPE) Pole Sign 1 Total Sign Sq. Foot Height Clearance Valuation Pole Sign 2 Total Sign Sq. Foot Height Clearance Valuation Monument Sign 1 Total Sign Sq. Ft. Height Valuation Monument Sign 2 Total Sign Sq. Ft. Height Valuation Wall Sign 1 Total Square Ft. Sign Wording Valuation Wall Sign 2 Site Address: Owner: Owner Phone Owner Address: City: Zip: Contractor Name: Contractor Phone Contractor Address: City: Zip: Contact Person: Contact Email: WA License Exp. Date: City Business License Parcel Contact Phone Fax ---PAGE BREAK--- Total Square Ft. Sign Wording Valuation Wall Sign 3 Total Square Ft. Sign Wording Valuation Wall Sign 4 Total Square Ft. Sign Wording Valuation Canopy Sign Total Sign Sq. Foot Height Clearance Valuation CONTRACTORS AFFIDAVIT: I HEREBY MAKE APPLICATION FOR A SIGN PERMIT AND CERIFY THAT OUR BUSINESS IS REGISTERED AS A CONTRACTOR WITH THE STATE OF WASHINGTON AND THAT ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH ALL CODES AND ORDINANCES OF THE CITY OF PUYALLUP. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. BY LEAVING THE CONTRACTOR INFORMATION SECTION BLANK, I HEREBY CERTIFY FURTHER THAT CONTRACTORS (GENERAL OR SUBCONTRACTORS) WILL NOT BE HIRED TO PERFORM ANY WORK IN ASSOCIATION WITH THIS PERMIT. I ALSO CERTIFY THAT IF I DO CHOOSE TO HIRE A CONTRACTOR (GENERAL OR SUBCONTRACTOR) I WILL ONLY HIRE THOSE CONTRACTORS THAT ARE LICENSED BY THE STATE OF WASHINGTON. _ DATE: / / SIGNATURE OWNER / AUTHORIZED AGENT PRINT NAME MINIMUM SUBMITTAL REQUIREMENTS: 1 (ONE) COPY OF SIGNED APPLICATION; 2 (TWO) COPIES OF SITE PLAN DRAWINGS FOR POLE AND MONUMENT SIGNS OR 2 (TWO) COPIES OF ELEVATION DRAWINGS FOR WALL SIGNS; 2 (TWO) COPIES OF SIGN DETAIL DRAWINGS; PLAN REVIEW FEE DUE AT TIME OF APPLICATION SUBMITTAL. PROVIDE FOUNDATION AND STRUCTURAL DETAILS FOR FREESTANDING SIGNS AND MEANS FOR FASTENING BUILDING MOUNTED SIGNS AS FOLLOWS: A. DIMENSIONS B. WEIGHT C. MATERIAL D. PARTIAL CROSS SECTIONS SHOWING ATTACHMENT TO BUILDING, GROUND AND STRUCTURAL MEMBERS (STUDS, BEAM, POST, WALL) AND FASTENING METHOD (BOLTS, SCREWS, LAGS, NAILS, WELDS). PROVIDE SPECIFIC DETAILS FOR ATTACHMENT TO EFIS SYSTEMS E. SIZE, SPACING AND NUMBER OF FASTENERS. F. SHOW ALL STRUCTURAL COMPONENTS OF SIGN ITSELF (SIZE INCLUDED) G. INDICATE IF THE SIGN IS TO BE LIGHTED, A SEPARATE ELECTRICAL PERMIT IS REQUIRED H. ALL FREESTANDING POLE SIGNS OVER 8 FEET ARE REQUIRED TO BE DESIGNED AND STAMPED BY A LICENSED WASHINGTON STATE ENGINEER REV 10/16 ---PAGE BREAK---