BP5240~,
,.
' BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~~'~ 2 Z' ~1 ~ Issue Date
Permit ~® 5 2 4 0
_ ~ C
Z-~ ~ ~ Permit Fee: $ ~~~~s~~
.JOB ADDRESS - ,
LEGAL
1 ' DESCR. LOT N0.
~~~ BLK. TRACT l
~L~ Y l ~t, i 1~~~~ ^ SEE ATTACHED SHEET
,Z. OWNER MAIL ADDRESS
~~ rY ~ ZI PHONE
,~" rz_Q_~a-~
3. CONTRACTOR ' ~ ` / MAILADDRESS /~ PHONE LICENSE NO.
l ~~CL1l~-~C~~ ~~/'1-Sl~F7UC~-LC~rl ~~ ~ ~C'X Z(~, `-~ ~/~iCL/~' ~/~(~ -~1~~
4. USE OF BUILDING
5. Class of Work: NEW ^ ADDITION []ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ 7~LC~~
]. Sq. FOOtage of StfUCture (Including Basement and Garage):
8. Change of Use From: Change of Use To:
g, Valuation of Work: $ ~~') ~ (~ C~C~ , ~'~C°
10. FIOOdplaln: Floodway Yes^ No Dev. Permit
Fringe Yes^ No BFE EIev.Cert.
11. Current Zoning:. (t r'~
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 2 S
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 fprm signed by the Building Inspector and stamped
'APPROVED'.
I here a ree to perform the proposed work in accordance with the specifications set forth
abov and in acco nce with the codes~ordinances of the City of Blair and the State of
Neb ska, under a that this permij i void if work is not commenced within 1 SO days
or i n le t 'n~~gts~ t o ue. Q J Z Z~
SI URE OF OWNERJCONTRII/A.C(`IUlTOR OR AUTH UORI/ZE/D AGENT - J DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Site Plan Attached ^ Complete Plans Attach
C'
Approximate Completion Date ~~~- ~
Inspections Required and Fees
Uti 'ties
Sewer Tap ~/ ~ S•C~C~~-f~J~, c_ Water Tap /1
Sewer ~~ 4 ~ CX~ ~ Water Service ~ ~ ~• ~<1
Septic
Remote
~~~ Building
Footings ~ 2 ~ ~' Drywall '~
(before finish)
Framing' Final ~ Z 3
Electrical
Rough-in " 7',t Ck 5 S~'~ ~.,~'~ Fixtures
Final / n~ cK ` Permanent Service ~
Temporary Service
~j 2 ~~~~ Me hanical
Rough-in~ C~ :~~U -~'xlcfv~ ~~,a,~C _r/ /Q ~C~ .~
Final ~- ~- . C1U `'~ - .
Ground Work ~ - ~J~ ~~~
Rough-in ~ L~ ~CX-s ~ ' ~ ~'
/!2-~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approv d B .
CATION
Rev. 10/91
BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
Application Date: u_ ~ -~ ~j Issue Date: L{" ~.U ' ~ Permit Fee: $ ~~- C I
JOB ADDRESS
LEGAL
1' DESCR. LOT NO.
~ ,~ BLK. TRACT
~~~i f-
f~_(°'~~' ^ SEEATTACHEDSHEET
2 OWNER
I~~r ~ MAILADDRESS ZIP PHONE
3. CONTRACTOR ~
-~- c-K_~ MAILADDRESS
~f~ ~~ t~c-~ ~ C~C~ ~~f~.~-le_ PHON LICENSE NO.
~`~ ~ ~ ~~t ~'
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~-~}{~~c~~_
7. Sq. Footage Of StrUCfUre (Including Basement and Garage):
8. Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Floodplain: Flooawey Yes^
Fringe Yes^ No ^
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 _
TION ACCEPTED 8Y 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 City of Blair and the State of
Nebraska. I understand that this permit is void if work is not commenced within 1 SO days
or is not completed within 2 years of date of issue.
SIGNATURE OF OWNERfCONTRACTOR OR AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in ~ < <~ ~~ Fixtures
Final Co ~ C~C~ Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Ground Work Plumbing
Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
5264
Comment: Approv By:
• ~• BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
Application Date: ~ j -~ ~(-C~ Issue Date: `~ • Z`~ ~ ~~~ Permit Fee: $ ~~_
JOB ADDRESS
LEGAL
1 ' DESCR. LOT NO.
~ ~ BLK• TRACT I~
V~{~ I/~ 1
~ ~~,
^ SEE ATTACHED SHEET
2. OWNER /7 MAIL ADDRESS IP PHONE
3 CONTRACTOR MAIL ADDRESS PHONE LIC NSENO.
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work; ~ /
~`
7. Sq. Footage of Structure (Including Basement end Gerege):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
1Q FIOOd laln: Floodway Yes^ No ^
p Fringe Yes^ No ^ Dev.Permit
BFE
EIev.Cen.
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 _
APPLIC,QTIO~~~'T~D~~~~ PLANS CHECKED BY I APPROVED FOR ISSUANCE BY I
~ NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air condi-
tioning, and septic systems. By my signature below, I acknowledge 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 Inspectorand stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the spedfications 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 not crompleted within 2 years of date of issue.
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date ~~-1 ~~
Inspections Required and Fees
Sewer Tap 7S~ (~~~ UtilitiWater Ta
p
Sewer ~~~ ~~ Water Service l 0. C~ C
Septic
Remote
Building
Footings .Drywall
(before finish)
Framing
Final
Electrical
Rough-in Fixtures
Final Permanent Servioe
Temporary Service
Mechanical
Rough-in ~ -~-~= ABC ~ ~ ~~~
Final ~ ~ CCU
Ground Work Plumbing
Rough-in C~; • ~~ % Final I Z - ~~~
5332
OF OWNER~CONTR/ACTOR Otj
///~
OF OWNER (IF OWNER BUILDER)
AGENT DATE
~ -`,~ ~~-
DATE
J
wrltN NrfoPERI_Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved _
SOUNDS PRTG: elelr, NE _ p„„ „~,~,
CITY INSPECTION SLIPS
~~
Inspection has been requested for
Location of Building
A
By a-
Name of Compan
On c~
At " Co
Type ~~ Inspection
Date
Results of the~ns ec '
p t ior~/
~~Sm
~s~~__ ,
Time, ~ ~~1~
re :~'~'~~~' e
City Representative
,.~~,, ,.
CITY INSPECTION SLIPS
Inspection has been requested for ~~ ~,,an/
~+ Location of Building
By ~ti~ ~~~_.
Name of Company
Type of Inspection
At ~ ~ ~-
Date Time
Results of the Inspection are: (~~
.~L~~~ ~
City epresentative