Fill - Free fillable APPLICATIONFORSIGNPERMIT CITYOFBRIDGEPORT,BUILDINGDEPARMENT Toerecta sign On Street Sizeofsign OwnerofLand (City of Bridgeport) PDF form

Form1204(4.3.20)

PermitNo.

_________

CITYOFBRIDGEPORT,BUILDINGDEPARMENT

APPLICATIONFORSIGNPERMIT

Date_____________

Toerecta sign On Street

Sizeofsign OwnerofLand

OwnerofSign Owner’sestimateofvalue

SignErector Address

SignErectorPhone Email

CommoncouncilApproval

ApprovedBy R. No SignFee:

Theundersignedherebymakesapplicationforapermitfortheerectionofasignassetforthintheaccompanying

drawingsandspecificationshowingconstructionandmethodoferectionasrequiredbytheBuildingDepartment.

Ifhungonwallsofbuildinggivethicknessandmaterialofsame

Ifonaroof,giveconstructionofroof

Constructionofsign

Locationofsign(Streetandnumber)

(Owner's)(Agent's)Signature

Address

Signcontractor

Address

TYPEOFSIGN

 GroundSignRoofSignWallSignMetalBoxElectricMarqueeChannelLetters

Lengthofsign Height Weight

Maximumheightofsignfromtheground

Isilluminatedsignlisted builtwithlistedcomponents

CONSTRUCTION

 Metal  Wood  PlasticwithMetalFrame

METHODOFERECTION,BRACES,ETC.

Sizeofangleorflatirons chains,cablesorsignhooks

Lagbolts,etc. size,length&spacing

Remarks

HOLDHARMLESS/RELEASE

CityofBridgeportandBridgeportBuildingDepartmentrequirethatpermitteeshallindemnifyandhold‐harmless"City/Department",itsemployees

andagentsandreleasebothfromanyandallclaimsonactionsbroughtbythirdpartiesforinjuriesordamagesofpropertyinconnectionwith

grantingofthispermitandworktobeperformedthereunder.Permitteemayberequiredtoinsureagainstsuchclaimsinamountsappropriateto

meetsuchobligation.City/Departmentshallhavetherighttoreviewandspecifysuchamountandscopeofcoverageasitmaydeemappropriate

foractivitiesconductedunderthispermit.

SignatureofOwner/Lessee

SignatureofContractor

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APPLICATIONFORSIGNPERMIT CITYOFBRIDGEPORT,BUILDINGDEPARMENT Toerecta sign On Street Sizeofsign OwnerofLand (City of Bridgeport)

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