EL-2013-00191_0001.tif i
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building er 't Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
EL- 2013 -00191 of a www.blairnebraska.org
06/0612013 bpeterse ELECTRIC Residential June 6, 2013
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LOCATION OF IMPROVEMENT: 501 S 25th St, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: Dennis P And Carol Penry CONTRACTOR:
<t 501 S 25th St Blair, NE 68008
A.m BLAIR, NE 68008-0000
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NATURE OF WORK PROPOSED USE
Sub -Work New Const Primary Residence
PROJECT NAME PERMIT EXPIRES 06106/2015
501 S25thSt- 130423- Addition
ESTIMATED COMPLETION DATE 616/2015
DESCRIPTION OF WORK
Wiring for inside of the house. 12 total outlets switches and fixtures.
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 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 Offici , shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
plica i'on.
Date
igna re of Applicant