EL-2013-00058_0001.tif CITYOF BLAIR
t 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
M� B uilding Permit Application (402) 426 -4191 -Phone
. � (402) 426 -4195 -FAX
EL- 2013 -00058 ° Mrs e of a° www. blairnebraska.org
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03/05/2013 bpeterse ELECTRIC Residential March 5, 2013
LOCATIONOFIMPROVEMENT: 1078 S 16th Ave, Blair, NE 68008
ARCHITECT: GENERAL Hipnar Electric
OWNER: Gregg R And Sara J Andres CONTRACTOR: 9332 State Hwy 133
1078 S 16th Ave Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Sub -Work New Const Primary residence
PROJECT NAME
PERMIT EXPIRES 03105/2015
1078S16thAve- 130129 - Remodel ESTIMATED COMPLETION DATE 3/5/2015
DESCRIPTION OF WORK
Electric for main floor kitchen remodel.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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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 B Inspector is issued.
5. The undersigned owna ageri agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance-* it the" codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with, Pi ithout the intention of the undersigned or any alteration or change from this application without approval of the
Buil g pfficial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
app.' ion.
Date
ature of Applicant