BP1027MECHANICAL PERMIT APPLICATION,
Jurisdiction of City of Blair, Nebraska ~~~~ c,~ ~,
218 South 16th Street ~' ~ /~?~~` `
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Blair, Nebraska 68008
(402) 426-4191
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Application Date: ~~ Permit Fee: $
JOB ADDRESS z ~ '' ~ ~~
LEGAL
1 • DescR. LOT NO. BLK. TRACT
O SEE ATTACHED SHEET
2. OWNE MAIL ADDRESS ZIP PHONE
3. CONTRAC MAIL ADDRES _ HONE r, , L ENSE NO
d\'~tl i
4. Class of Work: O NEW RESIDENTI O EW COMMERCIAL O REMODELING/ADDITIONS REPLACEMENTS
5. Describe Work:
Comments:
MECHANICAL PERMIT FEES
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~ Forced Alr S
stems
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Per Unit Commercial/Residential (New) .........................~ ........ $2`5.00
I
Air-Conditioner Unit
Per Unit Commercial/Residential (New) ..... ............................ $10.00
Refrigeration Units/Coolers
Per Unit Commercial (New or Replacement) .............................. $10.00
NOTICE
I hereby certify that I have read and examined this
application and know the same to be true and correct
All Forced Air Systems/Air Conditioner p t~
. Unit Replacement
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
Per Unit Commercial/Residential (Replacement) ........................ $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local
law regulating construction or the performance of
construction. - ~ ~~
Permit Issuance Fee .............$15.00 ,~
_ ~,~ ('4
TOTAL ~~ -"
SIGNATU CONTRACTOR OR AUTHORIZED AGENT
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Current License on File 7 Y s O No O NA
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D
ATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approv~y'
71 INnS PRTr -Rlalr. NF Rev. 12l
BUILDING INSPECTION REPORT
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OF BI:AIl2 ~ ^ WASHINGTON COUNTY ^ OTHER
[!CITY
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L~A°'I'~ON OF INSPECTION: ~ G~~ ~ ~ ;-~'-~
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RACTOR
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NAME OF OWNER: ~ CONT
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DATE INSPECTION REQUESTED. ~ ' ~ PERMIT N0. ~~~~
TIME INSPECTION REQUESTED. .~f-'~ ~~ .
TYPE OF INSPECTION REQUESTED: ~
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BUILDING:
^:FOOTING ;: ^ FRAMING • ^ DRYWALL : ^~FINAL .
"-.:.UTILITIES: -; .: ,., :. _ ~.' .._. . ~ _,._ ... ,.~ ._ _ °-
. ~" n SFWFR TAP ' n SEWER rl SEPTIC f l WATER TAP
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