BPM1936
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MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
o 900 c<lt3&8 ....._ aO
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7"1. 8 L-{ 17 - J t3 - /;2 12B pde;flmt Fee: $
. tpej .4<!-
d ,')0 :5" P~A ~.
Mail Address p .,()" C';b, >l 3 t.., s ~
~ t~Ag0ss f J )~ Av<- ",1 F;",11-v~ ZiP, f/J ') S-
COMMERCIAL 0 RESIDENTIAL D New 0 Addition 0 Alteration 0 Repair
~
Application Date:
1 tl'- 3o/u1
Job Address
d i1fh..- ~
Heat Pump
Central A/C
3
;}.
Tons
Tons
Furnace
BTU/H
AlC
# of Units
Furnace
Completion Date: \ \ - 9, \)~
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.................... ....... ...$100.00
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.
/ /-;;l(D?
Date
M 1936
Phone
Phone
" J.i - O:lf'l .f
o Replacement
io \'-{
P o:t(y
(
~
ECHANItAL PERMIT FEES
3o.JJ
Furnace/Heat Pump/Air Conditioner (Per Unit)
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
Modular Home...... ............ ............. $50.00
Permit Issuance Fee... ...... ... ...... ........ $25.00
Total
Current License on File ~es 0 No 0 N/A
Comment: W J .~ '
/ / d t;o?--i4~ (l..-ti~
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: ;]). PJ/~
I
Rev. 2008-10
~
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska 1\ 9 t\l.\I~
B~~i~,~~~~a;~: ~t~;~i 1 J
Fax (402) 426-4195 E 3162
(402) 426-4191
Application Date: I [) ,~ 3 0 .- 07
Permit Fee: $ Yo 0' JJ
s. N~UJZ~;j
p.O. to).. 31oS-
W / (i 'rp7 ~a:zb~
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: .=:> j ~
13, t~r~
Job Address
Service Fee = (Amp Fee + $5.00 per branch circuit)
1-100 Amp Fee......... ...... ...... ..$25.00
10 1-200 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 oflaws 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.
Jv-~
rized Agent
I-d 1/ rJ1
Date
~Wl
Zip
Phone
Zip
Phone
o UPGRADE SERVICE
ELECTRICAL PERMIT FEES
Upgrade Existing Service........... ..$25.00
Temporary Service.................... $15.00
Fire Alarm System................. ....$15.00
Signs (each)........................ ......$25.00
Miscellaneous Apparatus......,., .....$15.00
/ S~~UJ
CommerciallMulti 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
();;-: CD
YO ,oJ
Total
Comment:
I
Rev. 2008-10
QbJ
D CITY 6F ~~AIR .
D WASHINGTON COUNTY
BUILDING INSPECTION REPORT
/ (J If J3-~ Ie:; (/IL.( (.(.
I
S'-+.
LOCATION OF INSPECTION'
NAME OF OWNER' I {o/ i(~ 4:
CONTRACTOR'
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(~)\(,".i'"f ;:~ ">( l'T /'i~~i (; J"~'oc
DATE INSPECTION REQUESTED'
I 5t)
TIME INSPECTION REQUESTED' l\" /1'
PERMIT
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATERTAP 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:
PASSED FAILED
D D
MECHANICAL:D ROUGH-IN ":K]" Nc~tl FURNACE D RADIANT HEAT \Kf FINAL D PARTIAL
lor \.,"<,., ,i'" ""'\~ /,1 "~'>\
CO~~__2io~ -Ikt,~--t_:_ ~::r()tJ ~ f=I'.-6K1).i-euC
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
P~ED ~
~~
COMMENTS:
PASSED FAILED
D D
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
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INSPECTOR'
frJ~+
DATE OF INSPECTION MADE:
TIME' 1).;5- Cj
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
1/ ;]0
BY
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D CITY 6F ~~AIR ..
BUILDING INSPECTION REPORT
g ~ 't ~- r~ u'fL{ tI. S--\-,
D WASHINGTON COUNTY D OTHER /
LOCATION OF INSPECTION'
.= '0":.\'="""'-
i
NAME OF OWNER' 1(';/'/'(,:
I,f.'
DATE INSPECTION REQUESTED'
CONTRACTOR'
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C:)(~"'''l?~ :;,( i-,.; r'/i, .:; ,J,>-"\
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TIME INSPECTION REQUESTED' ! \.
,t-'TT"""'"
..
PERMIT
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 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 '.0"
II """;"""
COMME~~_ 3~ N _ iJ.~jf<'L ~rt~ ~~ .Ai<fI?w, ti'~.v"Ue<IC
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D
D PRESSURE TEST
FURNACE D RADIANT HEAT
FINAL D PARTIAL
P~ED ~
""""""""'~,iall;ig:S~IW.I;!.~&lilll2Wg:!~.2=~
PARTIAL
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
/if 0 fovJc~ ye-f-
{'tt-L-L (=?JZ Ie. t -' (N~fCd(b'A./
f\J Die' ,:) f-rrt-c w<~ L L tv ce JL {c? .::TWit! ccf. e t e cf4.("""c~ .
INSPECTOR'
14~+
DATE OF INSPECTION MADE:
TIMF' I J.;$- 0.
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
j/ ;]0
BY