EL-2010-00036_0001.tif I
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Rug 11 2010 7:56 HP LRSERJET FAX page 2
Au;. 11, 7010 9:09AM CITY OF BLAIR (402. 426, 4191) No. 5606 P, 2
CITY tW BLAIR
2118 S. 18TH STREET
BLAIR, NESS M814A 88008
Building Permit Application (402)426.4191 -Phone
- o+ (02) 426- 4186 - FAX
EL- 2010 -0 036 a 'o�„ 6 � q www.Malrnebraskm
00M012014) bpaterae ELECTRIC ftes]dentist August 11,
LOCATIONOFIMPROVEM14T: 1606 Wilbur St siafr, EVE 68008
ARCHTE;CP GOAL
• Electrical Systems, Inc.
•
wit' Go W And Susan E Thomas coNtr�CToR:
y ' 149128 A Cir
1806 Wilbur St
Omaha, WE 6814#
BLAIR, NE 6600$0000
0 7
NATURE OF WORK PROPOSED USE
Misc, Permit Primary Residence
PROJECt NAME PERMIT EXPIRES 08M012012
13689 ESTIMATED COMPLETION - DATE 2
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DESCRIP*10N OF WORK
200 amp iervice for basement remodel
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor RES0901COMeheck SUBMITTED: NA
DIE P OSIT MLt?: BUILDIN PLANS SUBMITTED; NA
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1. Na work 'il bE started befor$ a permit is 16SUE0 AND POSTED.
2. For corny oreial permits, a set of plane for this project must be submitted to the Nebraska State lire Marshal's Office for review.
3. Separa/e!permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The uncle owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not. be commenced until a
copy of alpermit signed by the Building Inspector is issued,
s.The und�rsiigned owner or agent agrees to perform the proposed work In accordance with the specifications set forth above and
In accor nce with the codestardinanoes of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shell constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
appileaiton. ss
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signature of cant l®
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