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Sign Permit

APPLIC. DATE PREMIT NO.

This permit is igsued to the Owner/Builder named below, for the purposes of
the construction, demolition, plumbing or related work described herein. The
validity of this permit is subject te compliance with the plans and other
documents submitted with the permit application, and to the compliance with
the "Port Coquitlam Building and Plumbing Bylaw".

(name)

(address) . (address)

(city) (city)

(postal code) | (phone #) (postal code) | (phone #)

PURPOSE. _
OCCUPANCY -

CONSTRUCTION VALUE

‘SIGNATURE oF
OWNER /AGENT

"PERMIT FEES AND DEPOSITS:
~ Sign Micro Fee oe
Sign Permit Fee | Per Sign Value

TOTAL FEES AND DEPOSITS

THE ISSUANCE OF THIS PERMIT SHALL IN NO CASE BE TAKEN AS ASSUMPTION OF
RESPONSIBILITY BY THE CITY FOR ERRORS OR VIOLATIONS oF CODES, STATUTES OR
BYLAWS ok | — -

_ BUILDING OFFICIAL