EL-2010-00011.tif i
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ELECTRICAL PERMIT APPLIC
Jurisdiction of City of Blair, Nebraska
218 South 16 Street
Blair, Nebraska 68008
Fax (402) 426 -4195 E 3235
(402) 426 -4191
Application Date:
'7" 2 " l Permit Fee: $
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Job Address
Owner r it Address zip Phone 5/5 qS
2 ontractor J/� � _Mail
3. Class of Work: O NEW RESIDENTIAL 0 NEW COMMERCIAL EMODELING /ADDITIONS O UPGRADE SERVICE
Describe Work: C/ � �/ L
4.
5.Current License on File es C1 No 0 N Completion Dat
ELECTRICAL PERMIT FEES
Service Fee = (Amp Fee + $5.00 per branch circuit)
Upgrade Existing Service .............$25.00 00
1 -100 Amp Fee .......................$25.00
101 -200 Amp Fee .......................$35.00 Temporary Service ................... $15.00 $15.00
201 -300 Amp Fee...... $55.00 Fire Alarm System ................
301 -400 Amp Fee .......................$75.00 Signs ( each) .............................. $25.00
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401 -500 Amp Fee .......................$95.00 Miscellaneous Apparatus ..............$15.00
501 -600 Amp Fee ..................... $115.00
601 -700 Amp Fee .....................$135.00 Commercial/Multi Family and All Upgrades:
701 -800 Amp Fee .....................$155.00
801 -900 Amp Fee ..................... $175.00 # of Circuits x $5.00 ff�
901 -1000 Amp . ........................$195.00 Amp Fee
IF OVER 1000 Amp
1" 1000 Amp Fee ..................$195.00 Amp Fee + Circuit Total
Each additional 100 Amps ......... $20.00
New Residential: (Finished Area)
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Single /Two Family Dwellings
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Notice sq. ft. x.063
I hereby certify that I have read and examined this
application and know the same to be true and correct. All Modular/Manufactured Homes ....... $50.00
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or Other: (alterations, additions and modifications)
not. The granting of a permit does not presume to give Receptacles /Switches/Lighting Fixtures (I 10 volt only)
authority to violate or cancel the provisions of any other
state or local law regulating construction or the # of Apparatus .......... x $1.00
performance of construction.
Power Apparatus (220 Volt or higher) j
# of Apparatus....... I x $8.00
Smoke Detectors..... °T x $3.00
Signature of ontractor or Authorized Agent
Permit Issuance Fee ...................$25.00
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�C/l lJ Total
Date Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By:
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Rev. 2008 -10