BPE0408ELECTRICAL PERMIT APPLICATI®N ~aG~~~~_ ..A
Jurisdiction of City of Blair, Nebraska '~~°~ ~`~~'~'°~`~" `
218 South 16th Street ~'~~~
Blair, Nebraska 68008
(402) 426-4191 Permit ~ 4 ~ 8
~3lq~
Application Date: ~~-~ a~--~ ~ Permit Fee: $o~2~A, 0
JOB ADDRESS ~ ~ ~ G~GT~~'l~~l~ ~/~ C
LEGAL
1 • DESCR. LOT N0. BLK. TRACT ~
~
O SEE ATTACHED SHEET
,~ OWN -P MAIL ESS„ ,~ ~%~iL2~ _ •~. /~~, / t~` ~
.-
G
'~ `_
~ ter /, !~~
~1
E LICENSE No.
PHO
N
CONT TOF- L~ MAIL ADDfIESS
3. ~/O i~ ~a~ ~~>a
4. Class of Work:.. O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE
5• Describe Work: !~~
6• Current License on File Yes O No O NA
ELECTRICAL PERMIT FEES
New Service Fee = (Amp Fee + $2.00 per branch circuit)
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service .,.... $10.00
101-200 Amp Fee ............................ $ 18.00 Tem ora Service $10.00
p ry ................
201-300 Amp Fee ............................ $ 30.00
301-400 Am Fee $ 42.00
p ............................ Fire Alarm S stem $10.00
y """"""""'
401-500 Amp Fee ............................ $ 55.00 Signs ..................................... $15.00
501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11 00 +'
• ~/ d G
601-700 Amp Fee ............................ $ 80.00
701-800 Amp Fee ............................ $ 92.00
801-900 Amp Fee ............................ $105.00
Commercial/Multi-Family and All Upgrades:
~ ~
901-1000 Amp ................................. $117.00 # of Circuits x $2.00 i ~/
IF OVER 1000 Amp Amp Fee i
1/
1st 1000 Amp Fee ....................... $117.00 111111
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
work will be complied with whether specified herein 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
X ~~ Power Apparatus (220 Volts)
aratus x $3
00
# A
pp
.
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
/D •- ~ ~ _ ~ ~ Permit Issuance Fee $15.00 ~ ~• ~ °
DATE
TOTAL /_ ` ~ O
co
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
~ ~
POUNDS PRTG: Blair, NE Rev. 12!95
~ l