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APPLICATION FOR UCC SIGN PERMIT
Today's Date
(Required)
Site Information
Political Subdivision and County names are required.
Facility Name (name of company, mall, institution, university, etc.):
Building and/or Tenant Name
Street Number and Name
(Required)
City
(Required)
State
(Required)
Zip Code
(Required)
Political Subdivision
(Required)
County
(Required)
Contact Name
Phone
Previous L&I File Number (if sign was previously approved or if electric circuit will be pulled from building):
Proposed Sign Information
Signs
Ground Sign
Marquee Sign
Pole Sign
Projecting Sign
Roof Sign
Wall Sign
Combination Sign
Sign dimensions:
Height
Width
Sq Ft
Sign Materials
Method of attachment
Illumination:
None
Electrical
Incandescent
Fluorescent
Neon
Note: If illuminated, all electrical details must be shown on drawings.
Plan Requirements
Three copies of detailed plans and specifications for the proposed sign must accompany this application. These must be drawn to scale on pages which are at least 18” x 24” and sealed by a licensed architect or engineer. These plans must detail:
The dimensions of the sign and any supporting
If roof sign,
the height from the roof level to lowest part of sign and height from roof surface to the top of the sign.
If ground sign,
the height from ground level to the top of
If a wall sign,
the dimensions of the wall surface of the building to which it will be attached and the location where sign will be attached.
If a free-standing sign,
the setbacks from property lines, buildings, driveways and the edge of an improved road or curb (shown on a plot plan).
The materials, finish, and the construction including loads (wind & seismic), stresses, anchorage, any illumination, and the fail-safe provisions for animated devices (if any).
Other pertinent engineering or construction data.
Applicant & Owner Information
Applicant Name
(Required)
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Property Owner
Same as the applicant
Owner Name
(Required)
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
(Required)
Email
(Required)
Filing Requirements
FEE SCHEDULE:
For an up-to-date listing of fees, please see the Fee Schedule listed on our website (
www.dli.pa.gov/Individuals/Labor-Management-Relations/bois)
or contact our office for a copy of the Fee Schedule by telephone at 717-787-3806 option 1 or by fax at 717-783-5002. Be sure to include any additional information necessary when mailing this application and the appropriate fee to the Department.
Invoice & Payment
Where should we send the invoice?
(Required)
Enter the name and the mailing address or email address the invoice should go to. Payment can be made by check (mailed or dropped off at our office) or by card.
