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BP4756~, ' ~I~ILDING PERMIT APPLICATION • Jurisdiction of City of Blair, Nebraska ~~ 218 South 16th Street ~ _ _ Blair, Nebraska 68008 ~~ 4756 (402) 426-4191 Permit - - - - ~/ h ., Application Date: /` ~`~ (~( Issue Date: ~ ~Z~ ~~ Permit Fee: $ ~(>~ JOBADDRESS LEGAL 1 ' DESCR. LOT NO. ~ BLK. TRAC n ~ C r'~~ ~ ^ SEE ATTACHED SHEET 2, OWNER ~"1 ~ ~Ce_ C,~ C o ~ MAILADDRESS p a.S ~nC' C' rte. ~ ~ ~ ~ -C PHONE ~0 0 3, CONTRACT R ~~ i~ IS~n ~ n ~ ~ MAIL ADDRESS ~ PHONE ~ ~i'~f r LICENSE NO. D ~ ~.~ USE OF BUILDING 4. ~.~ ~ ~ 5. Class of Work: ~W ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: r' ~~ t ~,Q .e~c~ 7. Sq. Footage of StrUCtUre (Including Basement and Garage): ~ `~ ~ ~ ~ ~~ 8, Change of Use From: Change of Use To: g, Valuation of Work: ~,~~~, ~ pU ~o 10. Floodplain: FI°Daway Yes^ No~j Fringe Yes^ No Dev. Permit Elev. Cert. BFE 11. Current Zoning: ~ ~. ~ 12. State Fire Marshall Required: Yes ^ Nod 13. Special Use Permit Required: Yes ^ No []' 14. Variance Required: Yes ^ No 0 15. Minimum Setbacks: Front 2~ Side ~_ Rear 16. Sidewalk Required: Yes 0 No ^ Waiver Approved ACCEPTED BY I PLANS CHECKED BY I APPROyED FOR ISSUgNSiE 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 awpy of this application form signed bythe Building Inspector and stamped 'APPROVED'. I hereby agree to perform the proposed work in accordance with the specifications setforth above and in accordance with the codes~ordinances of the City of Blair and the State of Nebr derstand that this rmit is void if work is not commenced within 180 days Is not comp) ted within 2 ye of of issue. s ~~ /~ ~~ SIGNATU . F OWNERJCONTRACTOR OR ORIZED AGENT DATE SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Site Plan Attached Complete PI ns Attached Approximate Completion Date ~ ~~~~~ Inspections Required and Fees Utilities Sewer Tap -'~- Water Tap •/ Sewer .~ `~~ Water Service / I 0 'UO - l~t,ns Septic +f lU'~~ ^ ~On .~nbSe Remote y1 5' ~-(o-~'Z Building Footings / 1~-q "y I Drywall ;~ (before finish) C~ Framing °~ Final ~/ ~ ~ ~~'~ l Electrical _ ~-~~ %~ Rough-in /(.Q~uU (?cm £IP Fixtures Final / [n~UO ~(?~ Permanent Service /~ `~ ~~~~ Temporary Service Mechanical Rough-in O~~.Ob ~D~r:s -3-q'C`~ IU'OU Final ~ ~~~ '+y7gr Plumbing Ground Work ~ ~,3 <<c, Rough-ir~_ fOla•UV ° 14x' s ' ~inal,~lv-UU WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved B .~ ~~~ ~~ ~„ ~~ ~~ NDS PRTG: Blalr, NE ^"`'• "'~" CI~IECK LIST FOR ISSUING RF:SIQENTIAL QUILQING PERMITS Site 1. 7.oning ~ I~ ~.- ('lood Plain: Yes No /. • ___.~ . 2. Permitted Use ~~ ' 3. Special Use ~~ Special Use Permit Issued ~1. Location on Lot (Setbacks) a. Front Yd. Required ~ 5' Shown 3 S~ b. Rear Yd. Required Z ~~ ., Shown ~ ~~~~ c. Side Yd. Required - ~' Shown "~ -~ r,. Variance Required; YES NO ~ G. Lot Area Required _ (_~aoo Actual 7. Lot Covdrage Allowed Actual 0. Other Structures on Lot ~~ , Adjacent Lot ~ 9. Ut i 1 i t i es t3 9..0...,` ~~,,,,_, ~ ~` ~~~, ,~ Quilding Plans 2. ~. ~1. r. G. ). 1. Floor Plan a. Room Sizes '-~ b. Emergency Ogress ~~ Foundation Plan ~/ Framing Plan ~ a. Cross Sections `~ b. Stairs *~ Elevations and Grading ri ' Electrical ~ 14echanical ~ Plumbing ~ it ~/ ~~ J .CI~IECK LIST FOR ISSUING RESIDENTIAL DUILDING PERMITS Site 1. zoning ~ ~ L- Flood Plain: Yes _ No f 2. Permitted Use ~~ 3. Special Use _ b~ Special Use Permit Issued , 4. Location on Lot (Setbacks) a. Front Yd. Required ~- S° Shown ~ ,~' b. Rear Yd. Required ~ ~~ Shown ~ ~,~~ c. Side Yd. Required ~~' , Shown '~ --~ 5. Variance Required: YES NO ~ ~. Lot Area Required _ a o 0 ~._ _, Actual 7. Lot Coverage Allowed _ ~ ~ ,Actual fl. Other Structures on Lot ~ Adjacent Lot ~ 9. U t i 1 i t i e s~ 5~.~, c.~ ~,,~ ~ ~ 4 D~f ~ .-~~~~ c~ building Plans 1. Floor Plan a. Room Sizes ~ b• Emergency Egress 2• foundation Plan ~ 3. Framing Plan ~ a. Cross Sections `~ b. Stairs +-~ d. Elevations and Grading c,% ' 5. Electrical ~ C. Mechanical 1• Plumbing ~ BUILDING PEF~MITAPPLI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Site Plan Attached ^ Complete Plans Attached ^ Approximate Completion Date ~~ ~^~ Z- Inspections Required and Fees Utilities Sewer Tap Water Tap Application Date: ~~ I ~~ ~~ I Issue Date: ~ r ~ ~ `C12.. Permit Fee: $ "7Z •cs~ JOB ADDRESS I ~'\ ~j S~~e v b C~ee K t~r~ ~ LEGAL 1 ' DESCR. LOT NO. ~ BLK. TRACT ^ 5 ~ 1 'L ~~~/` ^ SEE ATTACHED SHEET 2. OWNER I ' (' )/ „ ! , C v~~~ J"l !~G -~ MAtL ADDRE S l ~ Z~ ~~n~ C ~ ZIP PHONE 3 CONTRACTOR ~~ ~. ~ ~ ~ ~ C j I~ t,~MAIL ADDRESS ~ (~~ C _ `t•r U PHON~ n ~ ~ ~~ ~~ SE NO. ~~ /~['t~7/ / USE OF BUILDING 4. 5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~~j ~d ~~1.`.) N~~3LQS2~ 7. Sq. FOOtage Of StrUCtUre (Including Basement and Garage): ~ ~ ~ S '~'~ 8, Change of Use From: Change of Use To: g, Valuation of Work: $ l ZU ~ (~ 10. FIOOdplaln; Floodway Yes ^ No ^ Fringe Yes^ Na ^ Dev. Permit BFE Elev. 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 _ APPLICATION AC,C~EP1TE~D BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY 1 1~C~ 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 setforth 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 completed within 2 years of date of issue. SIGNATURE OF OWNER~CONTRACTOR OR AUTHORIZED AGENT DATE SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Sewer Water Service ~ U • O~ Septic ~ ©' ~ Remote Building Footings Permit ~~ _ 4795 Drywall - (beforefinish) Framing Final Electrical Rough-in ~~. UCH Fixtures Final ~ • ~~ Permanent Service Temporary Service Mechanical Rough-in ~• ~~ ABC ~ ~ ~ ~~ Final ~~• ~~ Plumbing Ground Work Rough-in ~ ~ W Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: PRTG: elelr, NE By. c /~`-° CATION Rev. 10/91 CITY INSPECTION SLIPS ~. ~ 3 ~ ~~n~~. llltQ ~- Inspection has been requested for Location of Building Name of Company On C7 cS t'~~~.La Type of I pection At iz/i Date Time `~ Results of the Inspection are: ~"` City Representative ' CITY .INSPECTION SLIPS l ddb ^ , ' Inspection has been requested for ~~ Location of Building By 011 /~~ ~lV~` X Name o Company On P~)C~., Type f Inspection At J ~~ 1 ~ ~ 2 ~~ ate Time Results of the Inspection are: ©7~ ~ ~~~~ City Representative CITY INSPECTION SLIPS- / ` ,, ,, ~, . • / ! Inspection has been requested for ~ae~-hse.n ~ ~7`~3yZK~J~ ~" / Location of Building By ~~~ ~~yl~fiucK-/~- Name of Company On ~'! -~7S ~ P~b~ ~~~m~~,~,IEIQC - G~-L-e- ~, •2~S Type of Inspect o~ At .~-a3 ~Z A. ~VI Date Time Results of the Inspection are: ~(.( Ci Represent~ve CITY INSPECTION SLIPS Inspection has been requested for fV ~ ~' ~L~ _ / j Location of Bu di g By (V ~~l ~/~ ~ ~~~~I Name of Company (Type of Inspection) At ~-1~--~ z ~ . _ Date Time Results of the inspection are: Ci Representative CITY INSPECTION SLIPS Inspection has been requested for By ~ C~-e~~~-- Name of Company Type of Inspection At 7 Cor~12 ~; ~d Date Time Location of Building Results of the Inspection are: ,{~ ~ City Representative ~/~ ~~ Y _- ~, ~<~est~ec~ze~Jk - ~cs~n CITY INSPECTION SLIPS Inspection has been requested for ~^ E~-L_~_ t~,P~_~~~~ ,'.=___ _°=a Location of Building , Name of Company On ~:a ~~ ~~ (Type ot'Inspection) At ~ ~'(~ _ Date ~ Time Results of the inspection are: (~'G~~ City Representative !~` . CITY INSPECTION SLIPS Inspection has been requested for ~ --.-e.. c..r~.~.-~ Location of Building By ~ ~ -.~ ,ti--a.~.~.-~ Name of Company ~~ Type of Inspection At ~ ~~- D°ate Time Results of the Inspection are: ty Representative ~'1 ~ ~~ ,~ , ~. i~ ~ ~ ~ ~;, ~ ~., ~ ~ ~ ~ ~ o {~': ~~ %v - ~ ~. ~,, ~ti ~ z,+ c~ :a ~~ i ~, `` °-~=2 !:~ . ~~ C': ~)ao:k t~ n \ a ~ /6' r~ ~ ~~ ~''~ a >°- ~- ~ -a ~ ~ t\ may, , ~~~ r,,,......_"'"'/ + ' . - _.. ~ I ~ =_ F ~: '~ , _ - ~` l. __ . _ . ~r ;` I ~ ~ , ,~ ~~3 -i 1 t.` 0 ~ X ~b pQ ~ ~ -~ i ! V ~ ~ \ ~ ~ ~P / n1 ~ ~ ~ I ` i, ~ ~ ~' ~ ~')~ ~ `d -.. • _, ` __.~` ._ /~ f ~ (i p °~ 0 ;~ ~ o, zn 1' ~. ~E~ ~~