Application for Pre-Approval – Security Lighting and Camera Reimbursement Grant

Name

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Ownership

Property Owner

Tenant ((written owner authorization required)

Property Owner

If tenant, Property Owner Name:

Owner Contact Information:

Property Information

Address

Address 2

Tax Lot Number (if known):

Property Type:

Commercial

Residential

Check here if you have additional properties to add to this application

Additional Addresses

Please list all additional installation addresses and tax lot numbers (if known) you would like to add to this application.

Total Application Amount

Please multiply the number of addresses by the grant funding ($500 for commercial storefronts and $250 for residential properties) and list the total grant amount you are applying for.

Proposed Security Improvements

Exterior security lighting

Exterior security cameras

Combination of lighting and cameras

(Check all that apply)

Description

Brief description of proposed installation (type, quantity, purpose):

Contractor Name:

Business Name:

Phone

License Number:

(All installations must be completed by a licensed contractor when permits are required.)

Estimated Project Cost:

Requested reimbursement:

Commercial property – up to $500 per storefront with separate address

Residential property – up to $250

Building Permit Requirements

Some security lighting and camera installations may require permits. (see Permit FAQ included)

Applicants are responsible for confirming permit requirements prior to installation by contacting:

Oregon State Building Codes Division, Pendleton office
Phone: (541) 276-7814
Email: [email protected]
Address: 800 SE Emigrant Ave., Suite 360, Pendleton, OR 97801

All required permits must be obtained before installation. Permit costs are not eligible for reimbursement unless expressly authorized by the Urban Renewal District.

Check that you acknowledge the Building Permit Requirements

Camera Registration Acknowledgment

Yes

Not applicable (no cameras proposed)

(Required if cameras are installed)

If security cameras are installed using grant funds, I agree to:

Register the camera(s) with the Pendleton Police Department; and
Make recorded footage available to the Pendleton Police Department upon request, consistent with applicable law.

Installation Sketch

[ SPACE FOR APPLICANT SKETCH ]

Please provide a simple sketch below showing:

The outline of the lot;
The location of the building(s) on the lot; and
The proposed location of all security lighting and/or cameras.

(Hand-drawn sketches are acceptable. Labels and arrows are encouraged. Attach an additional page if needed.)

One file only.
256 MB limit.
Allowed types: gif jpg jpeg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 mp4 ogg wav bz2 dmg gz jar rar sit svg tar zip.

Applicant Certifications

Applicant Signature

Date

By signing below, I certify that:

The property is located within the Security District within the Pendleton Urban Renewal District boundary;
No installation has occurred prior to approval;
All work will be completed by a licensed contractor, if work requires a permit;
Any required building permits will be obtained prior to installation;
The sketch provided accurately reflects the proposed installation; and
I understand reimbursement is not guaranteed and is subject to funding availability and program compliance.
I understand typing my name in this space constitutes a digital signature

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.