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BPE0368
ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Application Date: "' ~ ~ ~- ~ ~° Permit O 3 6 8 Permit Fee: $ JOB ADDRESS . n LEGAL 1 • DescR. LOT NO! BLK. TRACT O SEE ATTACHED SHEET A I L ADDR SS 2 OW ~ ///~ w Z P PHONE N ~ y , ~ .L L~(X ~" l~~L 3 C RACTOR / MAIL AD ESS PHONE LICENSE N0. R,~A oa~~ ~ ~~ ~ ~i~a~ ~`~i~~a 4• C ass of Work; O NEW RESIDENTIAL O NEW COMMERCIAL ADDITIONS ~ UPGRADE SERVICE 5. Describe Work: d j't ~-C/C 6• Current License on File O Yes O No O NA New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES 1-100 Amp Fee ..................:......... $` 13.00 Upgrade Existing Service ...... $10.00 101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00 201-300 Amp Fee ............................ $ 30.00 Fire Alarm System ................. $10.00 301-400 Amp Fee ............................ $ 42.00 401-500 Amp Fee ............................ $ 55.00 Signs ..................................... $15.00 501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11.00 601-700 Amp Fee ............................ $ 80.00 701-800 Amp Fee ............................ $ 92.00 ~.4 801-900 Amp Fee ............................ $105.00 Commercial/Multi-Family and All Upgrade ~,~8 t, 901-1000 Amp ................................. $117.00 © # of Circuits x $2.00 ~ ~o ~,~„~ IF OVER 1000 Amp Amp Fee 1st 1000 Amp. Fee ....................... $117.00 Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total NOTICE New Residential: (Finished Area) I hereby certify that I have read and examined this Single/Two Family Dwellings application and know the same to be true and correct. All sq. ft. x .045 provisions of laws and ordinances governing this type of k ill b li i h d h h ifi d h i wor w e comp w t w e et er spec e ere n or not. The granting of a permit does not presume to give authority Receptacle/Switch Outlets to violate or cancel the provisions of any other state or local Fixtures x $.75 law regulating construction or the performance of construction. Residential/Commercial Appliance # Fixect Outlets x $3.00 Power Apparatus (220 Volts) # A aratus x $3 00 pp . SIGN OF CONTRACTOR 0 HORIZED AGENT O p .- o~l~-- ~ Permit Issuance Fee ............. $15.00 DATE TOTAL WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: POUNDS PRTG.-Blair, NE / Rev. 72/95 BUILDING INSPECTION REPORT e s~ f ,. 1