BP5846- - BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Permit
545
Application Date: "~1 JZ ~" ~ ~~ Issue Date: ~'Z~" l ~~ Pei ~='-?~'~~
JOB ADDRESS I ~~r\ C ~ ~~
LEGAL
1 • DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
(
2, OWNER ~ 1 ~ I ~ CC, M~ C,~ O SS J PN ZIP
(11/ ~ ~ I ' ~O~~U PHONE
PHONE
3, CONTRACTOR MAILADDRESS
.~~-~z ~~- ~h mG~..~ ~.~--1.(1 ~ ~~~c . (~ 2C~ ~ ~z~ LIC~SENO.
- - ~~ax ~-~emcin ~-
USE OFBUILDING
4.
EMOVE
OVE ^ R
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^
M
6. Describe Work: / _ I ~) -~-0 (~ ~ Z " 7 ~ n r Z "~ ~Prl ~ ~ ~ ~Z_ ~(~ /
" ~
~
C Ci ~ 1 ~f Ya GrI.N r/ ,~-yt C ~`~`
], Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Floodplain: FI°°dwriy 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 _
APPLIC~ IION r4~ C~TED 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 herebyagree 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 SO days
or is,n~t completed within 2 years ofdate of issue.
OF OWNERJCONTRACFOR OR
DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote '
~-2~s~' ~ . . f
Building
Footings Drywall
(before finish)
`~ ~ " Z ~ cj ~~
Framing Final
Electrical
Rough-in Fixtures
Finai Permanent Service
Temporary Service
Mechanical
Rough-in ~- n0 ABC ~ ~ ~ ~~~
Final ~~ ~~ ~
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
CATION
Comment: Approved By:
G~'~
OLINOS PRTG -Rlelr. NE RBV. 1019
BUILDING PERMITApPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
CAT101V
5832
Permit
Application Date: "~I '~~~y Issue Date: ~~{~~ ~ `-~ Permit Fee: $ ] ~;~~ .
JOB ADDRESS
~ l a ~ ~ ~U--rim w~ t ~. ~S~hrc~ I
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2. OWNER ~ MAILADD,ESS ZIP
~(ai~ ~~mm~nt ~~h~)~ , PHONE
CONTRACTOR MAIL ADDRES PHONE
s. ~.~z ch i~o~ >!I-~~n ~~ ~--I C ~ ~ E- 3~n~ S~_~_ LICENSE NO.
~c~x 7~ ~ ~`~m~~
USE OF BUILDING
4. ~~~j?
5. Class of Work: NEy~ ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~IJ - ~~~~ ~~~ ~~~ ,fir" ~/-~~h/etr ~.~-~~I
7. Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Floodplain: Ftoodway Yes ^ No ^ Dev. Permit Elev. 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 _
AP~ATION'~l ~PTED BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY I
f 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 acopyof this application form signed bythe Building Inspectorand 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 co pleted within 2 year f d to of issue.
.~
.. ~~
ATUR~ OF OWNER/C RACTOR UTHORIZED AGENT DATE o
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
~'~ ' ' `r~d~and Fees
- Ihttes
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
b -2g - ~i ~( N,tY v~~
Building
Footings Drywall
(before finish)
Framing Final ~~- ~ ~-`~`~
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in ~ Z - ~~ ~ Final ~„ C_;c~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG: Blelr, NE Rav. 1081
9