EL-2015-00123_0001.tif i
CITYOF BLAIR
° 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
�I� r (402) 426 -4191 - Phone
Building Permit Application
(402) 426 -4195 -FAX
EL -2015 00123 /Se o, aJO`� www.blairnebraska.org
03/1012015 ELECTRIC Residential March 10, 2015
LOCATIONOFIMPROVEMENT: 2132 South St, Blair, NE 68008
ARCHITECT:
GENERAL Dingers Electric
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v" OWNER: Cornelia S, Trustee Rabbass CONTRACTOR:
1334 Prospect Ave
189514oth Ave Blair, NE 68008
BLOOMFIELD, IA 52537
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NATURE OF WORK STRUCTURE
Remodel Primary Residential
PROJECT NAME PERMIT EXPIRES 03109/2017
2132SouthSt- 150310 - Electrical Upgrade
ESTIMATED COMPLETION DATE 3/31/2015
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DESCRIPTION OF WORK
New 150 amp service, 3 circuits
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
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 t ntion of thng undersigned or any alteration or change from this application without approval of the
Buildi g 9ffici al, sh I C094itute suffici t ground for the revocation of any permit issued which was based on the approval of this
ap icaf n.
Date
Signature of Applicant
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