BPM0277~- - ~ MECHA
NICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~" ~~~~ ~~
Permit Fee: $ ~
JOB ADDRESS ~j , ~ ~~ `~~~ ~~
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LEGAL
1 • DescR. LOT NO. BLK. TRACT
O SEE ATTACHED SHEET
OWNER - MAIL ADDRESS ZIP
2. ~ `V ~ ~~ I ~ LJ~CJ \ Z ~~ - ~~i PHONE
r3 CONTRACT R `~Mn ~ ~AICDDRE~X ~~~ ~/QH~1~ ,~ ~~~~~LICE~~~~~~
4• Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS PLACEMENTS
5. Describe Work:
Comments:
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~C~~ MECHANICAL PERMIT FEES
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Forced Air Systems
~~-~("L~ Per Unit Commercial/Residential (New)
~ $25.00
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Air-Conditioner Unit
Per Unit Commercial/Residential (New) .............. ........................ $10.00
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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
~ d ` ~~
. 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
~ s ~ ®~~
TOTAL C-'s-
SIGNATURE OF CONTRACTOR OR A ORIZED ENT
Current License on File es O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YO PERMIT
Comment: Approved By:
POUNDS PRTG: Blair, NE Rev. 12/95
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 ~ 2 7 7
(402) 426-4191 Permit
Application Date: ~- ~~ _`
Permit Fee: $ ~~~~~
JOB ADDRESS ~ ~ /, /~ ~~ "
V L/-~1Z~~r
(/`
LEGAL
1 • DESCR. LOT NO. BLK. TRACT
O SEE ATTACHED SHEET
,~ OWNER M ~ l ( ~ I ~ ~ O MAIL ADDRESS
'
' t ZIP ~ ~Z~ PHONE
MAIL ADDRESS
,3• CONTRACT
OR
e~`(~~-~ ~Iec~'~C. ~~C) V~• PHONE
~-`~~ ~re~~n i- ~~ ~6~ LICENSE NO.
7Z 7 - ~/ 9" ~
4• Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE
5• Describe Work: ,./~ ~_ ~ ~~,-~
6• Current License on File O Yes O No O NA
ELECTRICAL PERMIT FEES
New Service Fee = (Amp Fee + $2.00 per branch circuit) ~~ ~ OCR
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00
101-200 Amp Fee ...•....•..........•.....••. $ 18.00 Tem ora Service $10.00
201-300 Amp Fee ............................ $ 30.00
Fire Alarm S stem $10.00
y """"""""'
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 Upgrades:
901-1000 Am $117.00
p ••••••••••••••••••••••••••••••••• ~ ~~~
# of Circuits x $2.00 -
IFOVER 1000 Amp Amp Fee
1st 1000 Amp Fee ....................... $117.00 -\
CCU
Z
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
Power Apparatus (220 Volts)
# A
aratus x $3
00
pp
.
SIGNATURE NfiRA f1ROR",4UTWORIZED A NT
..,,~ _
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Permit Issuance Fee .....•.......$15.00
j S=~
DATE
TOTAL
~ 7-a C~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS YOUR PERMIT
Comment: Approved By; ~ L~~~.Gf
f
POUNDS PRTG: Blair, NE ~ Rev. 12195
~~