EL-2010-00234_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
r _a Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
EL - 2010 - 00234
/Se 01 o1 a� www,blairnebraska.org
1111212010 ELECTRIC Residential November 12, 2010
LOCATIONOFIMPROVEMENT: 1314 S 16th St, Blair, NE 68008
ARCHITECT:
.GENERAL Hiller Electric Co.
OWNER: Kenneth W Vopnford CONTRACTOR: 6404 Dayton St
1314 So 16th St Omaha, NE 68117
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Misc. Permit Primary Residence
PROJECT NAME PERMIT EXPIRES 11/11/2012
1314S16thSt- 101109 -1- Furnace Replacement
ESTIMATED COMPLETION DATE 2010 -11 -12
DESCRIPTION OF WORK
Wired a new furnace
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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– undersigned or any alteration or change from this application without approval of the
Building Official hall constit a suffi 'en ground for the revocation of any permit issued which was based on the approval of this
a lication.
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�nof plicant Date
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