SA-2013-00208.tif i
CITYOFBLAIR
` 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 - FAX
SA- 2013 - 0020 ' °nts� pt °�\ www.blairnebraska.org
06/18/2013 bpeterse GN -AW
SIN Commercial June 20, 2013
LOCATIONOFIMPROVEMENT. 642 S 19th St, Blair, NE 68008
ARCHITECT:
p GENERAL Clear Image Signs & Graphics, Inc
Mark D And Kimb erl OWNER:
CONTRACTOR: 1225 Dunbar Rd
r 16268 Kam" Fremont, NE 68025
.,
,OMAHA, NE 68130 -0000 i
3 k
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01 0 �211 "CS t "nd EaE. i
NATURE OF WORK PROPOSED USE
Sign Primary Commercial- Fremont Electric
PROJECT NAME PERMIT EXPIRES 06/19/2015
642S19thSt- 130618 -Sign ESTIMATED COMPLETION DATE 6/18/2013
DESCRIPTION OF WORK
Sign for Fremont Electric 2 signs.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck /COMcheck SUBMITTED: NA
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DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
N/A
;
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 Applicant Date
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PERMIT NO:
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ADDRESS K � S 19 4- �' 5 "
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APPROVED
(B�UILDING
PLANNING
PUBLIC WOR143
APMROVAL AS A RESULT OF AN INSPECTION
NOT BE CONSTRUED TO BE AN APPROVAL
V1 OF THE PROVISIONS OF THE
CODE OR OF OTHER ORDINANCES OF THIS ' �(4 u � . e
JURISDICTION.
RECEIVED
, JUN 17 zu 3
CITY Ur BLAIP,
NEBRAW,
Jun, 3, 2013 3:56PM fremont electric inc No,2223 P. 2
Ivrd L1iaska Slate r-iectricai i./iVisiOn i NbLU Page 1 Of 1
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NE BRASKA STATE ELECT Wiring Permit #2047179
IVISION Existing Construction
CONTRACTOR PERMIT APPLICATION Other Type Of InstallatiOn)
NEC 2011
PR03ECT DESO RPTION,
INSTALL NEW CIRCUIT FOR SIGN,
Inspection Fee Received $33.00 Estimated Completion Date! 06/28/2013
FEE DESCRIPTION LOCATION /BUILDING # QUANTITY COST TOTAL
EXISTING FEE 1 $75.00 $25.00
BRANCH CIRCUIT FEE 1 $5.00 $5.00
APPROVAL NOTICE FEE 1 $3.00 $3.00
., m ............................ _._._ ........ ..................... .... _.....-,. n ........... ............... ._._
Basic Fees for this Permit: $33.00
................ . ......................... ................................ _...n.:,,,,,.n ........,................ _ ......... _ ........ _ ............................ ......................
- -.,...................._._......_.__............. ........_.................._._�
Additional Service Fees for this Permit. $0.00
- --1111.1-1.1- ....................__ .__.........I..................
ALL Service Fees for this Permit, $33.00
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N EBRASKA STAVE E LECTRXCAL DIVISION R OUGH INSPECTIONS
800 South 13th Street
Gate Gate Date
PO Box 95066
Suite 100 Inspector Inspector Inspector
Lincoln, NE 68509 -5066
TEL (402) 471 -3550
FAX (402) 471 - 4297 FXNAL INSPECTION STATUS
Wiring Permit #2047179
Site Information Site Owner /Manager
II
FREMONT ELECTRIC, INC. LES SHALLBERG
642 S 19TH STREET 1245 HILLS ROAD
BLAIR FREMONT, NE 68025
WASHINGTON COUNTY (402) 720 - 3911
FOREMAN: ANDY KAVAN
Power Supplier Issued To:
OPPD FREMONT ELECTRIC, INC
716 FRONT STREET 1245 HILLS ROAD
BLAIR, NE 68008 FREMONT, NE 68025
(402) 426 -4151 PHONE: (402) 727 -4932
LESLIE SHALLBERG
LICENSE # EC 00499
For Inspection Contact,
DENNIS CARRAHER NEC 2011
105 MEADOW LANE
GRETNA, NE 68028
PHONE: (402) 332 -5044
DISTRICT #i3
Date. 2013/06/03 15.39:39 By: SED Online Permitting
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Jun, 3. 2013 3:56PM fremont electric inc No -2223 P. 1
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Fax Cover Sheet
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1245 Hills Road
Fremont, NE 68025
DATE; 1 �1
NUMBER OF PAGES INCLU COVER SHEE
TTO.
, t ° � - FROM:
Phone: P 4 9 -4—M A S
Fox Phone Phone: 402- 727 -4932
Fax Ph one: 402- 727 -8124
REMARKS:
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