EL-2013-00075_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
uildin Permit Application
402) 426 -4191 - Phone
(402) 426 -4195 - FAX
L -2013 -00075 � /Se of Qo www.blairnebraska.org
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111912013 bpeterse ELECTRIC Residential March 19, 2013
LOCATIONOFIMPROVEMENT: 2270 South St, Blair, NE 68008
ARCHITECT: GENERAL Keystone Electric
a OWNER: Michael P And Sarah J Boeka CONTRACTOR: 8777 Templeton Dr
P O Box 76 Omaha, NE 68134
BLAIR, NE 68008 -0000
., y 01 3 �7s - `'z,r :,-� *� W y.�,^- „Mr� =.�'
NATURE OF WORK PROPOSED USE
Elect /Mech /Plumbing Primary Residence
'ROJECT NAME PERMIT EXPIRES 0311912015
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2270SouthSt- 130319- Electrical ESTIMATED COMPLETION DATE 312512013
)ESCRIPTION OF WORK
Changing out a service. 200 amp.
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)EPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck /COMcheck SUBMITTED: NA
)EPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
No work will be started before a permit is ISSUED AND POSTED.
. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
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.
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.
Date
)nature of A cant