Sign Permit Application
Application Date: __________________________________ Permit No.: ______________________________________________________________________
PROJECT INFORMATION
Installation Address: _________________________________________________________________ Parcel ID: _______________________________________
Current Zoning: __________________________
Current Comprehensive Plan Designation: ____________________________________
Multi-tenant building Multi-building complex Single business property
Square footage of all existing signs: ___________________ Total Linear Street Frontage: ____________________________________________________
Square footage of new signs: __________________________ Total Linear Feet of Store Frontage: ____________________________________________
Type of Sign (check all that apply)
Single Faced Illuminated
Identification Sign Marquee Sign
Double Faced Monument Sign
Pole Sign Projecting Sign
Multi Faced Wall Sign
Directional Awning Sign
APPLICANT/PRIMARY CONTACT PROPERTY OWNER Same as applicant
Name:
_______________________________________
Name:
_____________________________________________
Mailing Address:
_______________________________________
Mailing Address:
_____________________________________________
City, State, Zip:
_______________________________________
City, State, Zip:
_____________________________________________
Phone Number:
_______________________________________
Phone Number:
_____________________________________________
Email:
_______________________________________
Email:
_____________________________________________
Relationship to
Property:
SIGN CONTRACTOR ELECTRICAL CONTRACTOR
Name:
_______________________________________
Name:
_____________________________________________
Mailing Address:
_______________________________________
Mailing Address:
_____________________________________________
City, State, Zip:
_______________________________________
City, State, Zip:
_____________________________________________
Phone Number:
_______________________________________
Phone Number:
_____________________________________________
Email:
_______________________________________
Email:
_____________________________________________
WA Contractor's
License Number:
_______________________________________
WA Contractor's
License Number:
_____________________________________________
Sign Permit Application
Page 2 of 2
SIGN SUBMITTAL REQUIREMENTS
Site Plans: Please provide three (2) copies. The applicant shall submit a dimensioned plan drawn at a scale of 1” = 20' (or other scale
approved by the Development Services Division). The site plan shall include a scale, date, north arrow, source of information and
contain the following items:
Location of existing buildings, parking, exterior lighting, signs, and landscaping.
Location of proposed sign(s).
For freestanding signs, identify required landscaping including a list of plant types and spacing.
Total square footage of existing and proposed signs.
Linear feet of street frontage and total linear feet of store frontage.
Sign Plans and Details: Please provide two (2) copies. The applicant shall submit a dimensioned plan drawn at a scale of 1/2” = 1'
(or other scale approved by the Development Services Division). The site plan shall contain the following:
Method of attachment for new wall signs.
Distance of any projection over the right-of-way and clearance above ground.
Foundation plans and wind and seismic lateral support for new freestanding signs.
Color elevations of the proposed sign design.
Sign length, height, and depth.
Sign face area.
Letter size.
Type of sign and base.
Illumination details.
Vicinity Map: Provide one (1) copy of a vicinity map on 8.5”x11” paper.
Application Fees: As required by the current City Development Services Fee Schedule.
SIGN PERMIT FEES
Description Number of Signs Fees
Minor alteration or reface See Development Services Fee Schedule
New Signs - Planning Fees See Development Services Fee Schedule
New Signs - Building Fees
$175 per Freestanding Sign
$ 75 per Monument Sign
$ 50 per Wall Sign
New Illuminated Signs $ 100 Flat electrical fee N/A
Automation Fees See Automation Fee Schedule N/A
Total Fees
STATEMENT OF OWNERSHIP AND HOLD HARMLESS AGREEMENT
Statement of Ownership:
The undersigned property owner(s), under penalty of perjury, each state that they are all the legal owners of the
property described herein and authorize individuals or entities identified herein as applicants to file this application
allowing for said property's development.
Authority to Enter Property:
The undersigned property owner(s) do hereby authorize employees of the City of Des Moines to enter onto property
described in this application to examine and inspect as necessary to process this development application.
Hold Harmless Agreement:
The undersigned, certifies under penalty of perjury, the truth and/or accuracy of all statements, designs, plans and/or
specifications submitted with said application and hereby agrees to defend, pay and save harmless the City of Des
Moines, its officers,
employees, and agents from any and all claims, including costs, expenses and attorney's fees
incurred in investigation and defense of said claims whether real or imaginary which may be hereafter made by any
person including the undersigned, his successors,
assigns, employees and agents, and arising out of reliance by the City
of Des Moines, its officers, employees and agents upon any maps, designs, drawings, plans or specifications, or any
factual statements, including the reasonable inferences to be drawn
therefrom contained in said application or
submitted along with said application.
Signature
Signature
Name
Name
STATE OF
________________
)
)
County of ________________ )
I, the undersigned, a notary public in and for the State of ________________, hereby certify
that on this
___ day of _______, 20____, _________________________ personally appeared before
me, to me known as the individual(s) empowered to execute the foregoing instrument,
and acknowledged that they signed and sealed the same as their free and voluntary act
and deed for the uses and purposes therein mentioned.
NOTARY PUBLIC in and for the State of ________________, residing at ________________ County.
My Commission expires: ___________________________
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