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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
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Permit Issuance Fee......................... .$25.00
Total t/ dJ. 00
Current License on File p(Yes 0 No 0 NjA
Comment: .r --L' .
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WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: p '0 ~
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Application Date: //-;1- 09
Job Address
Owner
1.
Contractor
2.
3. Class of Work:
Describe Work:
4.
Heat Pump Tons
Central AlC Tons
Furnace /tttl; 1100 BTU/H
# of Units AlC
Furnace
Completion Date:
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 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.
M 1940
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Phope
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Phone
o Alteration 0 Repair
eplacement
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MECHANICAL PERMIT FEES
Furnace/Heat Pump/Air Conditioner (Per Unit) /___5 00
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
I
Rev. 2008-10