BP4916BUILDING PERMIT APPLICATIOiV
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit
J!`~ /, ,~ ~ pC~
Application Date: ~~ ~~ Issue Date: ~~"' >~~ Permit Fee: $
JOB ADDRESS ~lJ~ ~ ~ ' - J-1 ~~
OVl'
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
OWNER MAILADDR S ZIP ~j~~(PHO
3, CONTRACTO~~ j~ MAILADDRESS PHONE L ENSENO.
USE OF BUILDING
4.
5. Class of Work: ^ NEW ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ G~ ~ ~~ ~.~ ~ ~ ~ ~ ~ ~ S~ ~ i-~ ~, C
], Sq. FOOtage Of StrUCture (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~5 G1G~ "~~
10. FIOOdplaln: Floodway Yes ^ No ^ Dev. Permit Elev. Cert.
Fringe Yes^ No ^ BFE
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No^
13. Special Use Permit Required: Yes ^ No ^
14. Variance Required: Yes^ No^
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes^ No ^ Waiver Approved _
ACCEPTED BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I achnowledge that payment of the
building permit application fee does not constitute issuance of this building permit. I further
agree that construction covered by this permit application.shall not be commenced until I
have received a copy of this application form signed by the Building Inspector and stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications set forth
above and in accordance with the codes~ordinances of the Ciry of Blair and the State of
Nebraska. I understand that this permit is void if work is not commenced within 180 days
or is not completed within 2 years of date of issue.
SIGNATURE OF OWNERfCONTRACTOR OR AUTHORIZED AGENT DATE
71
Site Plan Attached ~` Com_plet~ PI ~~a~~
Approximate Completion Date ~~
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final I ~'"~"qz-- " SceR~f~eh,~l,
Electrical
Rough-in .bb ~ ~o-r~ 5 ~`~~' Fixtures
Final (,.b~ Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final ~``
Plumbin~~ "
Ground Work
SIGNATURE OF OWNER(IFOWNERBUILDER) DATE Rough-in /~.f3bY~L~t/5 Final (,,~~ ~5
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approv By
+~® --4-916
POUNDS PRTG: Blalr, NE Rev. 10191
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BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street _ _
Blair, Nebraska 68008 ~0 4935
(402) 426-4191 Permit - -
ArNlicati~n ()ate: (~ Issue date: Permit Fee: ~ ~~1
JOB ADDRESS C ~~
LEGAL
1 LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
' DESCR.
OWNER ~ MAILA DRESS - ZP _ ~~ ~~ HOr,~
CONTRA TDR ~ MAILADDRESS r PHO E `~ LIC NSENO.
USE OF BUILDING
4.
5. Class of Work: ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~, ~~,~~,,,~ _~ ~ LE - - ~/~~
], Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10. FIOOdplaln: Floodway Yes^ No ^
Frin
e Y
^
^ N Dev. Permit Elev. Cert.
g
o
es BFE
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No^
13. Special Use Permit Required: Yes ^ No ^
14. Variance Required: Yes^ No^
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes^ No ^ Waiver Approved _
ACCEPTED BY I PLANS CHECKED BY I APPR~lED FOR ISSUANCE BY
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I achnowledge that payment of the
building permit application fee does not constitute issuance of this building permit. I further
agree that construction covered by this permit application shall not be commenced until I
have received a copyof this application form signed bythe Building Inspector and stamped
~~ 'APPROVED'.
Iherebya reetoperformtheproposedworkinaccordancewiththespecificationssetforth
above an in accordance with the cod rdinances of the City of Blair and the State of
Nebraska I understand that thj perrgi~is of ' work is not commenced within 180 days
or is not mpleted within 2 y ~s of, o s ue.
OF OWNER/CONTRACTOR OR
DATE
Site Plan Attached ^ Com le P ans Attached ^
Approximate Completion Date ~~/ '~~~
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service _
Septic Remote
Building
Footings wall
Dr
y
(before finish)
a
F
i Final
r
m
ng
Electrical
~ ~;
~
Rough-in
i> Fixtures
~~ ~~
Final ~> ~
Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Plumbing
~ Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approve y
ra tune oarr_ _wia, ua - Rev. 1019
BUILDING PERMITAPPLICATIOI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit ~ ~ 5 ~ 2 ~
Application Date: u ' Z~' q~ Issue Date: ~`~ ~Z Permit Fee: $ I ~ Gd
JOBADDRESS
X501 N~ ~3~ ~~
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2. OWNER ~~~ ~ /~ ~~~ IL ADDRESS J ~G ZIP PHONE
3. CONTRACTOR ~ ^' + ~ V, r c ^~ ~ ~~ OIL ADDRESS ~ /," ~, ~~ v m P~ E
l~.I V J ~/ ^^C~. 11r-- \ !^+(' ~ ~~ ~ _LI~ SE NO. _
V?v( /~.`+a~~'~
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~~ ~~~~~,),~ , ~~ ~ ~
7. Sq. Footage of Structure (Including Basement aed Garage):
$. Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes^ No ^
10. Floodplain: Fringe Yes^ No ^ Dev.Permit
BFE
EIev.Cert.
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No^
13. Special Use Permit Required: Yes ^ No ^
14. Variance Required: Yes^ No^
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes^ No ^ Waiver Approved _
APP ATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
~re~l ~
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I achnowledge that payment of the
building permit application fee does not constitute issuance of this building permit. I further
agree that construction covered by this permit application shall not be commenced until I
have received a copy of this application form signed bythe Building Inspector and stamped
'APPROVED'.
I hereby agree 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. I understand that this permit is void if work is not commenced within 180 days
or is of completed within 2 years of date of issue.
u ~ ~~ - ~
TE
-~ ---
Complete Plans Attached ^
In~np~ iquired and-Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
~, Rough-in ABC
Final
Plumbing
Ground Work/ oU ~ ~~
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough-In Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approve !~ : `
ruunu~ rn iu: nieir, n~
CITY INSPECTION SLIPS
C~ ~_
Inspection has been requested for 0~~~ ~. ~~ ~-
Location of Building
By ~~S`~~.Q~1n~ ~. E ~ftl/VvtCciv~ ~~hU ~ ~ _
Name of Company
on --~-~
Type of Inspection
at f I~ ~(~~ Z
Date Time
Results of the Inspection are: l~/
l.l~`-"~
City R resentative
~B1_ $S~tl
~~o~)
~~~
-.~r.~-- ~, .._-_ _ ~ ~ ,~ ------- - -- _ _
CITY INSPECTION SLIPS
Inspection has been requested for ~U~'1 ~ ~ ~~~~ ~~,
Location of Building ~ Q , ~ Q
By CIS °~2 2h ~~ ~ I~-i,~,rY1Cu'I 5 tc'S ~j PAC 1 - C~
Name of Company
on ~.~ ~~~C`~12.c`CO~~ `t'rdlrUl~~ (al~ .
~~ Type of Inspection
l
At ~-y`~Z j a:cc~ -,lo~~o
Date Time
Results of the Inspection are: .~ll~E ~_
~~-2
SrSY~t2.o~n~ "`s
~t ~ '
~~ ~~~ ~
City Representative
City of Blair
218 South 16th
Blair, Nebraska 68008
402-426-4191
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promise
August 28, 1992
Malloy's Plumbing, Inc.
4702 N. 30th St.
Omaha, NE 68111
Dear Mr. Malloy,
Per my phone call as of August 26, 1992, I am
returning the enclosed check in the amount of 59.00.
The plumbing fee for the City of Blair is $18.00.
Please sign and return the enclosed permit
application along with a check in the amount of $18.00
as soon as possible. We would also appreciate your
calling Bill Wilson, City Building Inspector, for your
plumbing inspections. I have enclosed his business
card.
Also, I have enclosed a copy of our current fee
schedule for your future reference. You may obtain a
permit anytime between 8:00 a.m. and 5:00 p.m., Monday
through Friday, at City Hall, 218 S. 16th Street.
Thank you for your cooperation in this matter. If
you have any questions, feel free to contact me.
Sincerely,
~~/~,
Brenda Taylor
City of Blair
Enc