Liberty Tax SP-04-077MERt~tAtd
660 E. wateMower LQ., Stc. 200,g~leridiaa, hD 83642 - Phpm@e 887-2g211 /Fag 887-129~7T
l~Sl\ H'i L~ ~r 1®
I. Legal Description: Lot ,Block ,Subdivision
2. Street Address (city will assign if new constwuction): ~~ ~ ~~~2U/~~ ~~'~
3. Owner: ~~u / /CG'i~ derr9 Phone: ~`~5~ ~~/ 7
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4. Sign Contractor: /~i~it<~ ~/~~~riC -5i`~~r5~ Phone: %G~°~~l~ Fax: ~~%-~~~-
Address: ~' ~~ <' l'~.-.~~ 'r4r .~'%vd Nam ~<t /~~ ~a .s'~ ~~~
5. Electrical Contractor (if different than sign contractor): Phone:
Electrical Contractor must have an electrical license to hook-up/install any and all electrical signs.
6. Project Name: ~i~c~r ~~ Tc X .Sc'rv'c° e
7. I hereby submit this Commercial Sign Permit Application to construct or install:
^ New commercial free-standing sign(s). Number of signs
^ Illuminated (must obtain electrical permit) -Value of electrical portion only: $
New commercial wall sign(s). Number of signs , , I
~ Illuminated (must obtain electrical permit) -Value of electrical portion only: $ ,Sb ~
^ Planned sign program. Number of signs
* Complete Planned Sign Program application form
8. Value of sign(s) $ ~~~`-~ (excluding cost of installation)
Requned Plans and Specifications (Please submit two (2Zco~ies ofthe following-Z
® Complete text to appear on sign (business name, logo, sub-titles, etc.) including size & lettering style (font).
® Overall sign dimensions (including base, wall area, background area)
® Construction materials
® Sign and lettering colors -include color samples or paint chips
® Exact, scaled location of sign on property or building. Include building elevations, property lines & any
adjacent sidewalks, rights of way from center of streets, landscaping, screening.
Comments: L~si/ r' S'~/~' ~c~ ///~r~r.i~~~~r~ ~r~~r// ~t~~~ -
DECLARATION: I hereby certify that I have completed this application in a true and correct manner. AlI City of Meridian
ordinances will be complied with whether specified herein or not. The granting of a pernnit does not presume to give authority to
violate or cancel and state or local law regulating construction.
~~ Date: / ~ -~Y
Signature of Owner or Owners Authorized Agent
OI'FICE USE ®NLlr
Sign Permit Fee: $
Planning & Zoning Approval: ~ ,~)//~F'/I Date: ~~ ZG ~~ `~`
. -
Building Departtnent Approval: Date:
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