EL-2010-00009.tif I
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ELECTRICAL C
Jurisdiction of City of Blair, Nebraska
218 South 16 Street
Blair, Nebraska 68008
Fax (402) 426 -4195 E+ 3237
(402) 426 -4191
Application Date: 7 1- Permit Fee: $ iw
Job Address �y 64
Owner Mail Address ' / . Zip Phone
1. !�
Contractor ail ddr�ss Zip Phone
2.
3. Class of Work: O NEW RESIDENTIAL il N COMMERCIAL O REMODELING /ADDITIONS PGRADE SERVICE
Describe Work:
4.
5.Current License on File O Yes O No O N/A Completion Date
ELECTRICAL PERMIT FEES
Service Fee = (Amp Fee + $5.00 per branch circuit) j
Upgrade Existing Service .............$25.00
1 -100 Amp Fee .......................$25.00 Temporary Service.................... $15.00
101 -200 Amp Fee .......................$35.00 Fire Alarm System............ • • • • • • •••$15.00
201 -300 Amp Fee .......................$55.00
301 -400 Amp Fee .......................$75.00 Signs ( each) .............................. $25.00
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
901 -1000 Am ..................$195.00
Amp Amp Fee
IF OVER 1000 Amp 0 0
1" 1000 Amp Fee ..................$195.00 Amp Fee + Circuit Total �
Each additional 100 Amps ......... $20.00
New Residential: (Finished Area)
Single /Two Family Dwellings
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)
# of Apparatus....... x $8.00
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Smoke Detectors..... x $3.00
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Signature of Contractor or Authorized Agent
Permit Issuance Fee ...................$25.00 -
H
T otal l[� ®° 00
Date Comment:
c
e •�
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By:
Rev. 2008 -10
BUILDING INSPECTION REPORT
CIT OF BLAIR ❑ WASHINGTON COUNTY E:l OTHER
LOCATION OF INSPECTION- . . . . . .
WNEL')<' J /
NAMEOFO CONTRACTOR .L_
PERMIT
DATE INSPECTION REQUESTEDL TIME INSPECTION REQUESTED� NO -- k
i
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE [:1 STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING E:l FRAMING ❑ DRYWALL ❑ FINALE] PARTIAL PASSED FAILED
COMMENTS: F] F-1
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ I REMOTE ❑ WATER SERVICE PASSED FAILED
- 1
PARTIAL
COMMENTS:
ELECTRICAL: El ROUGH INE] FINAL,Q, SERVICE E] TEMPORARY SERVICE ❑ PRECONNECT P S�SAILED
❑
PARTIAL F-1
COMMENTS:
, "
MECRANICAL:❑ ROUGH IN ❑ A/C ❑
FURNACE ❑ RADIANT HEAT
I FINAL PARTIAL PASSED FAILED
COMMENTS: F] F
PLUMBING: ❑ GROUNDWORK ❑ ROUGH-IN ❑ FINAL F-1 WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
E PRESSURE TEST I- ❑
COMMENTS:
❑ OCCUPANCY GRANTED CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS •
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INSPECTOR DATE OF INSPECTION MADE: C (JI I
FA6ED �OP \BURT TO CONNECT SERVICE: ON BY