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BP4933 BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street _ _ Blair, Nebraska 68008 ~p _ _ 49.33 (402) 426-4191 Permit Application Date: ~ ~ ~~ Issue Date: ~, o 0 Permit Fee: $ L~ JOB ADDRESS .~ ~ Cc~~n ~fi~- ~~. LEGAL 1 . DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET 2, OWNER ~~ ~ ~ MAIL ADDRESS _~ ~~ ~ ~O in SIP-~~e e~ ~ ~ c f PHONE ~~ ~~ 3, CONTRA ( 1 1S ~ MAILADDRESS ~ PHONE ~1~ LICENSE NO. USE OF BUILDING 4. 5. Class of Work: ^ NEW DDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~ ~ t ~ ~ ~~.~ ~ ~ ~~ ..~ mac, o ~~ 7. Sq. FOOtage Of StrUCture (Including Basement and Garage): / i ~/ c.o o-~~ 8, Change of Use From: Change of Use To: g, Valuation of Work: $ ~~ Q ~ ~ ~ G 10. Floodplain: Floodway Yes ^ No ^ Fringe Yes^ No ^ Dev. Permit BFE Elev. Cert. 11. Current Zoning: ~~ t~ 12. State Fire Marshall Required: Yes L`_fo/ 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 ACCERjED BY I PLANS CHECKED BY I APPFj~/ED FOR ISSUANCE BY NOTICE Separate permits are required for electrical, plumbing, heating, ventilating and air condi- tioning, and septic systems, ey 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~f work is not mmenced within 180 days or is nqt completed within 2 years of date pf i sue. n SIG AT RE OF OWNERJCONTRACTOR OR AUTHORIZED AGENT ~ DAT SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Site Plan Attached Com~je Pla Attache Approximate Completion Date "~-~~ ~~~ Inspections Required and Fees Utilities Sewer Tap Water Tap Sewer Water Service Septic Remote Building d~ Footings ~~D"~S"y2 Drywall `~ (before finish) Framing ~/ Final ~ ~ I'J~~°~ ~~ ~ Zo 9Z Electrical ~ Fl' _c~3 ,: ~,~~~' Rough-in!/ !~.(~O - I~tlV~S Fixtures Final / ~ tx1 `' Permanent Service Temporary Service Mechanical Rough-in/ ABC Final ~ Plumbing Ground Work Rough-in I~.O() /~ler~~.s~~' Final ~/ ~ ~~ ~~~~~2~5/c~ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approv d-By: COMMERICAL CHECK LIST 1. OCCUPANCY CLASSIFICATION _ ~ 2 2. TYrI; O1, CONS~'1tUCTION 3. BASE OF FOOTAGE _~ p~ a ALLOWABLE INCREASE ~ ~-°' ACTUAL AREA (~ `~ 4 . USE ZONING _~~ 5. PERMITTED USE ~o 6. SPECIAL USE PERMIT OBTAINED YES N0 7. SITE P.EQUIREMENTS: ZONING ~ UBC ACTUAL SETBACKS FRONT © ~p ~ ~ ~ ~ ,/ -~=~--i SIDE A ~ « ~~ SIDE B a ~' ~~ REAR ~ c LOT AREA .~ _ LOT COVERAGE f oB _ .. +~ 8. EMERGENCY EGRESS UIiC NFI'A 101 NUMBER OF EXITS REQ'D ~ - . DISTANCE EMERGENCY LIGHTING 9. FIRE PROTECTION UBC NFPA 101 SPRINKLER ~ J f .~ ~ ALARM , ` ~ W ~ ~ ~ -~== 10: OCCUPANT LOAD ~ ~~ 11. SANITATION REQ'I) SHOWN POTS M~_ 4l 1' iK ~_W f URINALS ;~ W M _W LAVATORY iri t~[~7 ~ hi~_~~] 12 PARKING REQ'D SHOWN HANDICAP ~_ _~.~ REGULAR ~~ ~ ,. `NEBRASKA STATE FIRE MARSHAL Plan Review ~~~.t..i Plans Reviewed By: L~ Main Office ^ District "A" ^ District "B" ^ District "C' ~Ras~p DATE 05~-1892 TO: RE: James i~. Ke11ey Acl.di~tion 715 South 10th Ke11ey's Fish & Seafooa ]~laix~, N:ia 68008 1250 Lincoln .. Blair, NE .- -• . . -• Preliminary Plans and ~ A Review forCompliance 0 Resubmit forApproval Specifications Reviewed with Handicapped (See remarks) Regulations is included ® Final Plans and 0 Shop Drawings Approved ~ Materials Reviewed Specifications Approved (See remarks) (~}:S~S) REMARKS: ~~~~~~ ~~il~^ ~ (~ S~`7 ~I ~ ;~ E~(1~~;~'fti, CCS Blair COde5 SIGNED:. • ~ ~. ~ ^ Main Office 246 S.14 Lincoln, NE 68508-180 (402) 471-2027 SFM-75 (Rev. 3190) WHITE -Recipient DUUG giUHBE1N ^ District "A" ~ District "B" 306 Lake Street 438 West Market 4 Beatrice, NE68310-3315 Albion, NE68620-1241 (402) 228-4249 (402) 395-2164 YELLOW -Fire Chief PINK -Deputy ^ District "C" 200 South Silber North Platte, NE 69101-4200 (308) 535-8181 GOLD-Office File GREEN -Extra . BUILDING PERMITAPPLI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Application Date: D ' ~ ~~2 Site Plan Attached ^ Comple~ Plans Attached ^ Approximate Completion Date Inspections Required and Fees Utilities Sewer Tap Water Tap JOB ADDRESS ~ ~Q ~ ~~ ~~ ~•7 ~~ ' LEGAL 1 ' DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET 2. OWNER ~ C\`~^ nC ~1 - ~ MAILADDRES~ ZIP ~~P~~~ ~~ ~ 3. CONTRACTOR MAILAD~~ / , ,• PHONE _~ - ~~ ~-4'~ ~"7[ ~ LICENSE NO. USE OF BUILDING 4. 5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~IeC'~~~. ~ ~ ~], Sq. FOOtage Of StrUCtUre (Including Basement and Garage): 8, Change of Use From: Change of Use To: g, Valuation of Work: $ Floodway Yes ^ No ^ 10. Floodplain: Fringe Yes^ No ^ Dev. Permit BFE EIev.Cerl. 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 _ 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 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. OF OWNER~CONTRACTOR OR AUTHORIZED AGENT DATE Sewer Water Service Septic o Permit N 5 0 21 Remote Building Footings Drywall (before finish) Framing Final Electrical Rough-in f'o.UO Fixtures Final ~~ •~~ Permanent Service Temporary Service Rough-in Final - Ground Work CATION Mechanical - ABC _ Plumbing SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approve BLJrrc-a-~-.~ ~-.C~~~--~. Issue Date: ~' ~ ~'~"-~ Permit Fee: $ f 2 • d POUNDS PRTG: 81a1l, NE nev. yule! BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 c (402) 426-4191 Permit N ` 510 7 Application Date: ~ ~ ~ ~n ~ ~ Z-- Issue Date: ~~' ~ ~f ~~ Permit Fee: $ 7~~6U JOB ADDRESS I~Sc~ Lln ~~-~.Iti 1 , LEGAL DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET 2, OWNER -C`` M ~ e ~~~ MAILADDRESS Zlp ~'r ~ ~.~ PHONE ~/ ~ / I, ^ rMAILADDRESS ~~j ~ ~~ NE 3, CONTRACTOR lJ/~~tl Y ~-...) 7/a 7 vl `~>/ ~ ~ LICENSE NO. USE OF BUILDING 4. 5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: 7, Sq. FOOtage Of Structure (Including Basement and Garage): 8, Change of Use From: Change of Use To: g, Valuation of Work: $ Floodway Yes^ No ^ 10. Floodplain: FriRga Yes^ No ^ Dev.Permil 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 ^ Site Plan Attached ^ Complete Plans Attached ^ Approximate Completion Date ~'~~ ~1~7 Inspections Required and Fees Utilities Sewer Tap Water Tap Sewer Water Service 15. Minimum Setbacks: Front Side Rear septic Remote 16. Sidewalk Required: Yes^ No ^ Waiver Approved Building AP ATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Footings Drywall ~Jl~jt./ (before finish) NOTICE a F i Final r m ng 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 Electrical 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 Rough-In FlXtures have received a copyof this application form signed by the Building Inspectorand stamped 'APPROVED. Final Permanent Service 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 Temporary Service 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. Mechanical Rough-in ABC NATURE OF WN CONTRACTOR OR AUTHORIZED AGENT DATE Final Plumbing /Vl/~w~' Ground Work ~ SI NATURE OF OWNER (IF 0 ER BUILDER) DATE Rough-in ~ 2 • Q C1 ~~ y Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approve By:~ ~.. ~ -~ POUNDS PRTG: Blelr, NE - Rev. 10/81 CITY INSPECTION SLIPS ~ 4 Inspection has been requested for Location of Building i Name of 0~ mpany a (Type~of11nspection) At 7 ~5 17 2.- Date Time Results of the inspection are: _ City Representative CITY INSPECTION SLIPS Inspection has been requested for _ ~ ~ ~ ~ ors- ~ -- _ ~~~~~ Location of Building y \ Name of Company ) ~ ~ On ? f~ ~`~, ~ ` (Type of Inspection) At Date Time Results of the inspection are: ~~ >._ ~L City epresentati:ve CITY INSPECTION SLIPS Inspection has been requested for 3 ~ ~t~• F ~~ f ,~ ) Location of Building Name of Company On ~cs75 ~~ (Type of Inspection) At ~ ~ ~~' Date Time Results of the inspection are: Cit Representative CITY INSPECTION SLIPS ~~ ~ ;~~r Inspection has been requested for location of Building By ~- ~"! N me Company On ( pe of Inspection) At ~' ~~ Date Time Results of the inspection are: ~~ _ ti C ty Representative ~::ity ••f Eclair '113 S '15th St. Eclair, Nc?L~rar~k:a 58c:u:~~ I n v ~~~ i ~~ e MCi :I~i aCF:V i~le~_harii~_al Servir~es 1~- fl L~r_~ ~~5£~ Eclair , N~ 5~ic:~c:~8 :~htii~ t~_~l~:c•=mar E: Date c:J'3/~':~/r~:~:: IV•::•. 57c:~ F'aGe 1 Due Date 1c:~/'~/'~ De~.~cr iF•~t i~_~n Ex•tended Flumbinq F:~~ugh °< Final i-4:~c:~:_:~' 1~3.s:~t:~ ~°~.~r : Jamey F•::el 1 ey 1'~~c:~ Linti.•.•l n st . ~`.~ Nyy ~~ ~ q~ ~ t ~~, o~„~~tiv w ~~16 8 Lg~'~ ~53~°z Suta-T~~~tal ~.8. Vic? Tax ci.'~i~ T~.~•t a 1 15 . '~i_~ Net T•.• 1-'ay ~. f3 . ':~c:~ ~~/o r~ J~ ~lea~. ~3~~ S q~ i ~~ ~ ~~. /~.oo I~ C 1~ I~ .~ ~~ ~~ i r s rho P ~1~ N~~ o~~ ~~ c ~1 ~ ~X~~7iU ~ ~~,i~y< ~ .~h ~ ~~~ 60