BP5432BUILDING P~RAAIT ~4t~PLICA~I°ON
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 5 4 3 2
(402) 426-4191 Permit
Application Date: ~'~ " lJ Issue Date: R~'~"~/~ Permit Fee: $ 30•~~
JOB ADDRESS ~ ~~ ~rn , ~ S~
"
LEGAL
1,
DESCR. LOT N0. BLK. TRACT
~ SEE ATTACHED SHEET
2. OWNER ~~ MAILADDRESS ZIP P~ E
3 CONTRACTOR FF,^, II ~ MAILADDRESS PHONE
Uv~l~ ~ c ~ CG~r• `~ ~ ~1 ~ ~ ~ LICENSE NO.
(achy/
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: (~~
7. Sq. Footage of Structure pnauding easement and Garage):
$. Change of Use From: Change of Use To:
g, Valuation of Work: $ 9G~, ~(~
10. Floodplain; Floodway Yes^ No ^ Dev.Permit EIev.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 _
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date ~ ~" 9.3
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic .Remote
Building
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 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 06'4WNER/CONTRACTOPrOR AWTHORI7~~AGENT DATE
OF OWNER (IF OWNER BUILDER) DATE
Footings
Framing
Drywall
(before finish) ,,, ~~A
Final ,~~~ ~i~2~~~3.~~
Elec#rical
Rough-in Fixtures
Final 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: App d By
o~----..
SOUNDS PRTG: Blelr, NE _ Rev. ~~
BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218~South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit
5388
((// ~~
Application Date: ~- f~ _ 73 Issue Date: ~ ~~~ ~ ~ Permit Fee: $
JOB ADDRESS ~ ~~ ~ r ~ ~~ ~ )
"~
``J,
1 LEGAL LOT NO. t
/,, /
-~ BLK. TRACT ^ SEE ATTACHED SHEET
DESCR. ~ L-F~7
Q
2 OWNER ~ ~ ' , I~~ ~ / MAIL ADDRESS ZIP PHONE
-
L~~~~/~ UCENSENO.
Q DRES~ ~ ~~ ~ A P~ NE
f ~ ~ M
3. CONTRACTOR
Q {%~
n
~/ J
~i
/
l ~ IN
~/`~'
c
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ C - ~~ ~G{C1ZM en
7. Sq. Footage of Structure pndudiog Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes ^ No ^ Dev. Permit
EIev.Cert.
10. Floodplain: F
in
e Y
^ N
^
r
g
es
o
BFE
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
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer WaterServioe
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 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 rk is not commenced within 180 days
Ar is~fiot completed within 2 years of date of is~e.
IGNATURE OF OWNER)CONTRACTOR OR AUTHORIZED A~ DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Septic
Remote
Building
Footings~~ ~~~ Drywall
(before finish)
Framing Final r~~~~ S
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Rough-in
Final -
Ground Work
Rough-in -
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Mechanical
- AID -
Plumbing
CCU- 5 ~ c- ~.~~ ~ t~ V~-~~~~ ~r e~,~...~~ , Appro e
._....__ ____ _.. .._ o-.. ~nro