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BP5236~~JIL~ING PERMITAPPLICAT10~1V Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 N~ 5236 (402) 426-4191 Permit a ~~ ~ ~l ~9~3 Application Date: Issue Date: ~- , ~ "~~ Permit Fee: $ JOB ADDRESS _~ ~~ 2 ~ ~~,. l Esc-~ 1 . LEGAL DESCR. LOT ~ ~~ ~ BLK. TRACT ~~~~ ~ ~,~/ ^ SEE ATTACHED SHEET 2, OWNER MAI ADDRE;iS ~~~1/7 ZIP l J -12 a _ ~j PHONE ~JS ~/ 3, CONTRACTOR MAILADD~ES ~ PHONE ~. IC NSENQ. USE OF BUILDING ~ 4. 5. Class of Work: ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: , ~ ], Sq. FOOtage Of StrUCtUre (Including Basement and Garage): $, Change of Use From: Change of Use To: g, Valuation of Work: $ O~ 10. Floodplain: Flooawey Yes^ No ^ Dev.Permit Fringe Yes^ No ^ 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 _ LICATI~~ ~~~ 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 Ci of Blair and the State of Nebras I understand that this permit is void if work is not mence ithin 180 days or i of c mpleted within to of issue. __ ~ ~/ rye ATUR OWNERfCONTRACTOR ORAUTHORIZED DATE SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Site Plan Attached ^ Complete. Plans Attached ^ Approximate Completion Date ~~i~ ~~`~ Inspections Required and Fees Utilities Sewer Tap Water Tap Sewer Water Service Septic Remote - Building Footings Drywall (before finish) C /r~` Framing Final ~ ~'~ ~ Electrical ~~ Z~~ Rough-in w~ C)b ~•3u~~ Fixtures Final w- Uv ~' Z` X1_3 Permanent Service Temporary Service Mechanical Rough-in ABC Final ~-~ =~%~ % - ~ -~ ~~-~ Plumbing Ground Work Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approu _ ~-- __. ---__ ____ _. - .._ Rev. 10/91 ~l~il/4J' r.~k~l/N~ X for /.?P ~- ~~- iz /¢PPRaX. ~ Ntl ~PfSy ~7ff~cr ~PFiYovAl/aw lNc( upFP q Nf~v df~ If NEW PART /riaN ~ F~ CE/.li~J~'S ANO A~rE,P,~ 6f ~.Y/S?/~/~ A.PE/~S N ~UILCING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 ~® (402) 426-4191 Permit Application Date: ~~ ~ `~ ~ ~ Issue Date: > yea ~' ~ Permit Fee: $ / Z - U~~1 JOB ADDRESS 1 ' DESCR, LOT N0: ~ ~ / ~ ~' BLK. TRACT ~- i ~ i ~ ®SEE ATTACHED SHEET 2, OWNER ~ 1 MAILADDRESS f ~:,-, ~S ~rt~~n~' ZIP PHONE CONTRACTOR ~~' MAIL ADDRESS 3. ~C ~,~ f- E~e C.~rr~c; 2 ~~ PHONE LICENSE NO. CG~~%C.. f.~~- `f~'S"770 USE OF BUILDING 4. 5. Class of Work: ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~. ~ ~ ~' CS~- ], 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 ^ Fringe Yes^ No ^ 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 _ APP~ATIO~'C,C`IT~D BY 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 applicatign 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 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 1 f30 days or is not c leted withi 2 years f date of issue. li 3 - ~~r -9,~ GNATURE OWNERS NTRACTOR OR AUTHORIZED AGENT 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) i F Final ram ng Electrical Rough-in ~o ~ U~ Fixtures Final ~~~ Uo 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 ~ment: i 5245 Rev. 1091 BUILDING PERMITAPPLI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 CATION Permit 5 2 5 4 Application Date: ~ ~'~~ ~~~~ Issue Date: ~~~ ~~ - ~ Permit Fee: $ ~° (~~ JOB ADDRESS ~~7Z ~ ~? cKs LEGAL 1 ' DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET 2. OWNER ~~ c.~.r'~ MAIL ADDRESS ZIP ~ i 'n ~ r7 PHONE 7 zi .~. CONTRACTOR - C~ \ ~/1 M~ A~~S~ ~~1,, ~ ~~r_ (10NE~_ ~ 1~ `~ ~~ LI ~~~Q~~ USE OF BUILDING 4. 5. Class of Work: ^ NEW ^ ADDITION ^ ALTERATION REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~~~~~ ~ 7. Sq. Footage of Structure (IROluding BasameRl and arage): 8, Change of Use From: Change of Use To: g, Valuation of Work: $ Floodway Yes ^ No ^ Dev. Permit 10. Floodplaln: Fringe Yesl~ No ^ BFE EIev.Cert. 11. Current Zoning: Site Plan Attached ^ Complete Plans Attached ^ 12. State Fire Marshall Required: Yes ^ No^ Approximate Completion Date ~-1~~- ~~ Inspections Required and Fees 13. Special Use Permit Required: Yes ^ No ^ Utilities Sewer Tap Water Tap 14. Variance Required: Yes ^ No ^ Sewer Water Service 15. Minimum Setbacks: Front Side Rear septic Remote 16. Sidewalk Required: Yes ^ No ^ Waiver Approved Building APPLICATION ACCEPTED BY ~~ PLANS CHECKED BY APPROVED FOR ISSUANCE eY Footings Drywall (before finish) 6 ~ NOTICE Framing Final 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 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 Final Permanent Service above and in accordance with the codes/ordinances of the City of Blair and the State of Temporary Service Nebraska. I understand that this p mit is void if work is not commence within 80 days or is not ompleted within 2 ye of da of.issp~ , __ ~/ MechanlCal ~ ~ '~/ Rough-in ABC ''. SIGNATURE:OFOWNERJCONTRACTOR RAUTHORIZEDAGENT ATE FInaI ~• ~~~~ 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 By~~ POUNDS PRTG: Blalr, NE Rev. 10J81 CITY INSPECTION SLIPS Inspection has been requested for By f.c~1C1~S r` C.%1 ~2./1 Name of Company On ~./n Q ~ y 1~"~ Type of Inspection c Date Time 3~ Z J ~ci~~~~t Location of Building Results of the Inspection are: (~ C ity Representative ~~'~ ~,, CITY INSPECTION SLIPS ~r u J` F ,. Inspection has been requested for f»'~C /~ Locatio of Building L~~/C Name of Company On (/~~ (Type.of nspection At Date Time Results of the inspection are:_ ~/ (/! _ ~~ City Representative