EL-2013-00491_0001.tif I
CITYOF BLAIR
` 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
1t apt (402) 426 -4191 - Phone
B uilding ermit Application
a, \��.�� (402) 426 -4195 -FAX ,
EL- 2013 -00491 �n„ o , a� www.blairnebraska.org
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10/18/2013 bpeterse ELECTRIC Residential October 18, 2013
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LOCATIONOFIMPROVEMENT: 1350 S 16th St, Blair, NE 68008
ARCHITECT:
GENERAL JCM Electric, Inc
OWNER: Frank W And Jacque Wilkins CONTRACTOR: 3333 S 6th St St
1350 S 16th St LINCOLN, NE 68502
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Elect /Meth /Plumbing
Primary �
PROJECT NAME PERMIT EXPIRES 10/18/2015
1350S16thSt- 131018 - Electrical 10/25/2013
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
Electrical for kitchen remodel
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COM check 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 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
Signature of Applicant