BPE0011ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 0 011
(402) 426-4191 Permit
Application Date: `~`` ~ ~
Permit Fee: $ `'~
J08ADDRESS
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LEGAL
1 • DESCR. LOT N0. BLK. TRACT
O SEE ATTACHED SHEET
2 OW R , MAIL ADDRESS ~ n ZIP PHONE
3 TRACTOR MAIL ADDRESS
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~2~ ~77~ LICENSE N0.
4• ass of Work: O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELIN ADDITIONS O UPGRADE SERVICE
5• Describe Work:
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6• Current License on File O 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 Temporary Service ................ $10.00
201-300 Amp Fee ............................ $ 30.00
Fire Alarm System ...:............. $10.00
301-400 Am Fee $ 42.00
p ............................
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
801.900 Amp Fee ............................ $105,00 Commercial/Multi-Family and All pgrades:
901-1000 Amp $117.00 # of Circuits x $2.00 ~ ~
IF OVER 1000 Amp Amp Fee ~ ~~~ ~
1st 1000 Amp Fee ....................... $117.00
Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total !`7, D U
NOTICE New Residential: (Finished Area) ,-
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I hereby certify that I have read and examined this Single/Two Family Dwellings G
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application and know the same to be true and correct. All sq. ft. x .045 ~
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provisions of laws and ordinances governing this type of
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ill
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d
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be compl
e
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
I
r / Power Apparatus (220 Volts)
F # Apparatus x $3.00
SIGNAT 0 CONTRA/'
OR OR AUTHORIZED AGENT
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Permit Issuance Fee .............$15.00
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DATE
TOTAL .~~• (? f>
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approve~y:
POUNDS PRTG.~Blair, NE Rev. 72/95
CALLED OPPD~- -'` Z O~CONNECTSERUICE:
WAN1'OFFICE STAFF TO CALL OPP,D\
E.S ~ NO
^ YES ^ N0 6CR 1