AirT Registration 2021CITY OF BLAIR
218 S 161h Street
Blair, NE 68008
(402) 426-4191
Fax (402) 426-4195
Email: building@blairnebraska.org
FOR OFFICE USE ONLY
Date Paid: �+
Receipt No: Q
Date Issues:
BOND EXPIRES:
CONTRACTOR REGISTRATION / LICENSE RENEWAL
AIR TIGHT HEATING AND COOLING
1704 N BELL ST #157
FREMONT NE 68025
Type of Business: CONTRACTOR LICENSE
Contact information on record:
ft
Please verify and correct the
company /business
biformation listed here:
Type:
Phone Number: Type: Phone Number:
Work
(402)719-5051 Fax
Cell
(402)719-5532
Email Address:
AIRTIGHTHVAC HOTMAIL.COM
Please submit a current reciprocating license or those which have expired:
Name: Reciprocating License: Expires:
Please submit new certificates or bond renewals or those which have expired:
Name: Certificate 6f;Liabilit ,or Bond: Expires:
Place a check in the box next to the licenses you wish to renew:
Renew? Name: License/ Re istration: Expires: Amount:
WEYHRICH LARRY MASTER MECHANICAL 1/01/2021 60.00
RIGGS DAN APPRENTICE MECHANICAL 1/01/2021 25.00
Please list any additional licenses or registrations..
Name: I License/ Registration: Amount:
I hereby make application to the Licensing Board of Blair, Nebraska and certify that I am competent and
experienced to engage in the above said vocation.
I agree to conform strictly to the Ordinances of the City of Blair, Nebraska relative to said vocation and obey all
orders, requirements and regulations of its lawful constituted authorities.
I also certify that all information contained in this application is true and correct. I will notify the City of Blair
of any changes in the information reported on or with this application form within 15 days of any change.
Authorized Signature
/ — '-� C) ~�
Date
N
ED