EL-2010-00083_0001.tif (2) i
' CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
402
B uilding Permit Application ( ) 426 -4191- Phone
(402)426- 4195 -FAX
EL- 2010 -00083
r �Mise Ot QuG www.blairnebraska.org
MENEM
0812712010 bpeterse ELECTRIC Residential August 27,
LOCATIONOFIMPROVEMENT: 10097 Co 29 Rd, Blair, NE 68008
I ARCHITECT:
GENERAL
OWNER: Tim Potts CONTRACTOR:
MJ Electric Co
3716 S 155th St
10097 Co 29 Rd Omaha, NE 68144
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Blair, NE 68008
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NATURE OF WORK PROPOSED USE
Misc. Permit Primary Residence
PROJECT NAME PERMIT EXPIRES 08/26/2012
13383 ESTIMATED COMPLETION DATE 2010 -08 -27
DESCRIPTION OF WORK
Wiring New House
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor REScheck/COMcheckSUBMITTED: NA
DEPOSIT HELD: BUILDING PLANS SUBMITTED: NA
N/A
i
1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned 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 a permit signed by the Building Inspector is issued.
5. The undersigned owner or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance with the codes /ordinances 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, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of Appl'cant Date
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