BPM1867
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ELECTRICAL PERMIT APPLICATION ". '1
Jurisdiction of City of..Blair, Nebraska 01\ e> 1.0
218 South 16th Street \
B~~~, (~3~)~1~~I\O~'.~xf E 3131
(402) 426-4191
Application Date:
-,;;2'7-09
Job Address
Service Fee = (Amp Fee + $5.00 per branch circuit)
1-100 Amp Fee... ... ... ... ... ... .....$25.00
101-200 Amp Fee.................... ...$35.00
201-300 Amp Fee...... ...... .... .. .. ...$55.00
301-400 Amp Fee...... ............ .....$75.00
401-500 Amp Fee.... .. ... ...... ... .. ...$95.00
501-600 Amp Fee.................... .$115.00
601-700 Amp Fee.................... .$135.00
701-800 Amp Fee......... ............$155.00
801-900 Amp Fee.................... .$175.00
901-1000 Amp.................... .... .$195.00
IF OVER 1000 Amp
151 1000 Amp Fee.............. ....$195.00
Each additional 100 Amps.........$20.00
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
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 to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
Signature of Contractor or Authorized Agent
Date
~/i (J ()
Permit Fee: $ ~) {/ ,
pd'
~f
/tlJt 75'
Zip
Phone
Phone
(2/,,;7. &/8/3.5'
ELECTRICAL PERMIT FEES
Upgrade Existing Service............ .$25.00 d J)~. pt)
Temporary Service.................... $15.00
Fire Alarm System.................. ...$15.00
Signs (each)........................ ......$25.00
Miscellaneous Apparatus......... .....$15.00
Commercial/Multi Family and All Upgrades:
# of Circuits x $5.00
Amp Fee
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x .063
Modular/Manufactured Homes...... .$50.00
Other: (alterations, additions and modifications)
Receptacles/Switches/Lighting Fixtures (110 volt only)
# of Apparatus .......... x $1. 00
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors. . . ..
x $3.00
Permit Issuance Fee................. ..$25.00
r)~ cJ 6
~'.J .
Total
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._~t .
Comment:
WHEN PROPERL Y VALIDA TED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: .~t? /?pfJ~~..-J
Rev. 2008-10
J u 1. ~7 ~..J0092J 3,:) ~P~rV U ~ OF BLA ~)4~2. 4 I6. 4191) CVV1 cI ~ c:Y Jl~. ) 729 r~'. 1
ELECTRI~~~ti!~~~~r~!!s~ICA TIOY
218 South 1 ~ Street _.~,,__.,./'
Blair, Nebraska 68008 ~
Fax (402) 426m4195 E 3131
(402) 426-4191
Application Date:
7-;11-09
Service Fee = (Amp Fee + $5.00 per branch circuit)
1-100 Amp Fee..........,...........,$25.00
101-200 Amp Fee.................... ...$3 5.00
201-300 Amp Fee....,..................$55.00
301 -400 Amp Fee,............... ....,..$75.00
401-500 Amp Fee....................,..$95.00
501-600 Amp Fee.................".. .$115.00
601-700 Amp Fee.................... .$135.00
701-800 Amp Fee...... ...... .........$155.00
801-900 Amp Fee..,..................$175.00
901 -1000 Amp........................ ,$195.00
IF OVER 1000 Amp
}'I 1000 Amp Fee..,........... ....$195.00
Each additional 100 Amps...... ...$20,00
Notice
1 hereby certify that I hnve read and examined this
application and know the same to be true and correct. All
provisions oflaws nnd ordinllnces governing this type of
work will he complied with whether specified herein Or
not. The granting ota permit does not pres\lme 10 give
aulbority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction,
Permit Fee: $ 6tJ. IJ ()
'75
Zip
Phone
Upgrade Existing Service.. .... .. .... .$25 .00 .:15. () I)
TemporalY Service.. .... ....... . . ..... $1"5.00
Fire Alann System... ...... ....... .....$15.00
Signs (each)...................... ........$25.00
Miscellaneous Apparatus.,...,... .....$15.00
Commercial/Multi Family and All Upgrades:
# of Circuits x $5.00
Amp Fee
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x. .063
Modulal'/Manufactw'ed Homes...... .$50.00
Other: (alterations, additions and modifications)
Receptacles/Switches/Lighting Fixtures (110 volt only)
#ofApparatus,......... x $1.00
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.. ...
x $3.00
Permit Issuance Fee................. ..$25.00
~5 f) ()
6(), 00
Total
Comment:
WHEN PROPERL Y VALIDATED IN THIS SPACE THIS IS YOUR PERMIT
Approved By: f?,; f ~
Rev. 2008-10
~
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1867
(402) 426-4191
Application Date:
II,
Job Address
2.
3. Class of Work:
Describe Work:
4.
Heat Pump
(!(
---
Tons
Tons
ft; f1-S
DTU/M~
4:::AI~
M f/I'JI+
3
# of Units
AlC
Furnace
Completion Date: (S ~ / ~ - t) Cf
Boiler Chart
BTU Fee
Up to 100,000....................... ..... ....$15.00
100,000-500,000................. ........... ..$30.00
500,000-1,000,000.................. ........ .$40.00
1,000,000-1,750,000....................... .$60.00
Over 1,750,000.................... ...... ....$1 00.00
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
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 to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
'---,
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5/Jr7ro1
Date
Zip
Phone
o Alteration 0 Repair 0 Replacement
~ti I PtHIl ~'d I", #J); II ~
ERMIT FEES
/ / .. !) If p()
Furnace Heat Pump AIr ConditIOner (Per Unit) U V .
Up to and including 100,000 BTU / 3Ton............................$15.00
Furnace/Heat Pump/Air Conditioner (Per Unit)
Over 100,000 BTU / 3 Ton.......................................... ...$25.00
Refrigeration Units/Coolers/Lines/Compressor - Commercial
(New or Replacement) (Per Unit)
... ... ... ... ... ...... ... .. . ... ... ... ... ... ... ... ... ...... . ... ... ... ... ... ... ..$15 .00
Boiler (use BTU Chart to left). .. .. .... . .. ..... ...
Appliance Vent/Fans..................... ...$10.00
Duct System................................ ..$15.00
Gas/Air Outlets.................First 5
x $6.00
. . . . . .. ..Additional
x $1.00
Radiant Heat Systems/Gas/Water
Piping System............................... .$50.00
to:o :"5". Modular Home............................... $50.00
Permit Issuance Fee... .. . ... ... ... ........... $25 .00
Total
O?~ 00
. c;lJ
Current License on File ~es 0 No
o N/A
comment::c~ 5-<" I;} .-07
WHEN PROPERL Y V ALIDA TED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By:
, 3- PJf~
Rev. 2008-10
O~FBLAlli
LOCATION OF INSPECTION'
BUILDING INSPECTION REPORT 7;;'/- t;3J7
o WASHINGTON COUNTY 0 OTHER
NAME OF OWNER'
CONTRACTOR'
DATE INSPECTION REQUESTED'
TIME INSPECTION REQUESTED'
PERMIT NO'
o STATUS CHECK
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
~_~_. ..__ H ,.__. .,._ _ ' _ _n ,_ _ .,n _ . _ .'._ _ _,,_ .'_ _ _ __ _ _ _,,_ ,"'~"_'P _ _ _ _", _ _~_ ___ _ _.._,_on__. _ .". "_ ,0-," __. _.. _ _._ _ _ _,_ _ ',_'_
__ ~ _ __._ __~_ __ ___ ~ ~___ _ ~___ _._.~".._.__ __ ___ __ _ _,__.. ___ _ _~. _ __ _ _ ___~__. m .'._. _ ..._ __~_ ___ _____ _ ___ _ _ _ _ ~_~___.~.__._. _,. .,._ ._.__.. _ _ _ ~~ _ _ _ __ _ ___ ~._._ ~._ _ _ _ ~~____~~. -., - - - - -- - -- - - - -- --
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
COMMENTS:
PASSED EAILED
o ~
,,_,,__ .','.'. ._".,.,,_.-. _._..___...~..._..._.'"__.__._._.., .__..__,._,.."..__,.__.,..__....___ ____,,_.,. _. - ___.____'_._'n.._..__.__.._.,_"'...... ...,. . .___..__..__.__..~__.."....,- ',,_.".' -,..._.. _.,. --__, ___ __ .. ,'__' --,..,.
~_ '" _.. ______~____~__.__~~,_._ _,_..._..___.___._~______~.__.______m ____... _,___ __ _ ____~_____ __ ____ ___~__._~ _._.__ _ ____~_ ____~.__ _____ _____ _~_______ _^_.'.__ __ ~______~~_ - --.-~-.- - --~----. -- -.' - . . - - - -- ..-- ----- ...- ---,
UTILITIES: 0 SEWERTAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATERSERVrCE
o PARTIAL
COMMENTS:
PASSED FAILED
o 0
~J:'.1::.':Z'f'..:'::::::::::'__::::": :=.::::::' ..:.:.... ~''::''::_--''''':'';'''::.'. ~':::::._' :.= ::",::'" ::''':'':.'::''''::'''::''':'':'''':.: ~:_ -...:..: :.::": .:___:...--_.::.__;-.:.:::.z:::::...::.::'::::::: ':...::..::::: : ::... '::.= = ~::.....: _ :..:.:..: _.:... ~.._. ..;.....:::...:..:::.:::.:._:..':....: :::,::. :::,:::: ':..::..:::. - :::,,,::,:,,::,'-::'::''':::''': ~ -:...::.:...:;:.. :::.::.:..:::: :'::'-~':::'::'.':-:= -:: :::,:.::"'=":"::'::'::::" - -..: - - ';:;:"':;''::''''::;:: :,-:~...:;.-- .;;:: .~',
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
MECHANICAL: 0 ROUGH-IN 0 Ale
PASSED FAILED
o 0
........-._.--,. '-' ,_. ... .----,..,-.-.-.-....- -, ., ".-' ..... .'-'--""""
.- -------~_._----------------- -. , .'-- -,. ---- --------------.- ----.-
FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
COMMENTS:
PBED ~
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
COMMENTS:
PASSED FAILED
o 0
=::'2:::'::"":" _":':::''':.'=::~_'':..=..=.'_:.' ::.....:;:...:... _"_-'::'::::::-:~:.>:"::.=.=.":::: _::. ..::__.:::::....c ':'::'::' ::. ::...:.::::...:.:::.:::. ::":.:_' ::":'::::;:::::.;::::";"":'::;::::'.- .;:. ..;:: --: ::.:....:...:. _ :..::.:::: _':::"":":':'.: ',,: ::::::',,: =,::",':..- .:.::...:.:::.._-.- _:::-:: :;::":"_:,~;:.:'::"_~' _.::... -: ::::::.::''':'::' '..:.:::.._ _''':''''::' =.:....:: _'_':"'_'';.'' _'::;:"':;-::;-::::::::; '::_':::"::": L:":::''': _::..' _ '__' _-":::.' .:. - :::
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
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NOTES/REMARKS'
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mSPELTOR~J)aJ~i:~
DATE OF INSPECTION MAL
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
*r F/ec.mc )~y~~-
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BUILDING INSPECTION REPORT
CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
,--1," .r
NAME OF OWNER'<~>~:/?' /J,:/
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t._ /</J i~. ,~~/}'! ,j,~:J&~l~Z,<l(?~>l,",""~
/ /' t / 'o,j"" ~ ,/"',',..,l,I,'. I,')" / ., ,:,_ J!/" l ~" f,.,'.,'":.'....!~,L:,~.'..)..."~
PI" c' ,/-/. _.r,.:7.:.....,> ,"1.1 ~" ..
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CONTRACTOR' {:hi' ,/ :2.: ~(] L~i/J/n ;(~?il j
LOCATION OF INSPECTION'
DATEINSPECTIONREQUESTED':'S",. / /l . (~) Cj7 TIME INSPECTION REQUESTED' <,'3 . (~t~~:) nfl.
PERMIT
TYPE OF INSPECTION REQUESTED:
BUILDING: 0 FOOTING D DECK FOOTING D FRAMING D DRYWALL
D CONFERENCE
FINAL D PARTIAL
D STATUS CHECK
PASSED EAILED
D ~
PASSED FAILED
D D
PASSED FAILED
D D
PASSED ~
D
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL 0 PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
COMMENTS:
MECHANICAL:D ROUGH-IN D AlCH. 'FURNACE D RADIANTHEAT
FINAL D PARTIAL
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
COMMENTS:
o OCCUPANCY GRANTED
*~ !?I~'.
DATE OF INSPECTION MADE: Os-:: ;;?~ TIMF' .;{ " I ~
INSPECTO '
FAXED OPPD\BURTREA
TO CONNECT SERVICE: ON
BY
I/tJ
GS}" CITY OF BLAIR
~ 7-""'- --"--, ~-'--
BUILDING INSPECTION REPORT
D WASHINGTON COUNTY
LOCATION OF INSPECTION'
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NAME OF OWNER' /' //",t.;;ilP
(:~/tl :/,f ,/lIZ4lt1'~'
DATE INSPECTION REQUESTED' Ii:? '5: l) i:;P'
/!'~~:} . ' /,~) t) /,}t ~i'{l
TYPE OF INSPECTION REQUESTED:
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL
D CONFERENCE
D PARTIAL
D STATUS CHECK
COMMENTS:
Heaf
rJ(e~
PASSED FAILED
)i1 D
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D A/C D FURNACE D RADIANT HEAT 'c:[Sl~FrnAL D PARTIAL
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
}(D F~ED
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
D D
NOTES/REMARKS'
INSPECTOR'
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DATE OF INSPECTION MADE: '? - '{ - 0 9
A I?f:..fvcf),,#
TIMF' 10:- A 0'i
FAXED OPPD\BURTREA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
NAME OF
D WASHINGTON COUNTY
D OTHER
,Ii
<' /'
GJ;'CITY OF BLAIR
DATE INSPECTION REQUESTED' (. .
c:.:) (l
, l '
TIME INSPECTION REQUESTED' / /:
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D
D PARTIAL
D WATER SERVICE
PASSED FAILED
D D
COMMENTS:
,P'
ELECTRICAL: D ROUGHIN.~:, FINAL
D PARTIAL
P'BED F~
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
D OCCUP~D D CONIlIl'I?NAL OCCUPANCY GRAN1'EIl
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INSPE~ ' '
~~D~PD\BURTR~~~ (1) D
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DATE OF INSPECTION MADE: c:!3-tJ3 ;:;;((lYl TIMF' / 0 .~3S
TO CONNECT SERVICE: ON
BY