BP6352BUILDING PERMIT APPLICATION ~-'~1ey
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 6 3 5 2
(402) 426-4191 Permit
T QG
Application Date: ~ ~ ~~ Issue Date: -~ ~ ~ ~~ ~ ~ ~ ~ Permit Fee: $ o~~~
JOB ADDRESS
LEGAL
1 LOT NO. ~~ BLK. TRAC / .. ^ SEE ATTACHED SHEET
' DESCR.
`J
OW ER AI ADD_RE~yS~ ZIP PHONE
~
~
2.
3, CONTRAC MAILAD S ~~ PHONE ~
n ~ E EN .
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): ~~~
$, Change of Use From: Change of Use To:
g, Valuation of Work: $ l ) ~
~~ ~~ C d ~
laln: Floodway Yes^ No ~~
10
FIOOd Dev. Permit Elev. Cert.
p
.
Fringe Yes^ No Qs BFE
11. Current Zoning: ~~ 1~l
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
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 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 work is not commenced within 1 SO days
or~ot ~ ~et~within 2 year of~te of i ~e.
SIGNATURE OF OWNERiCONTRACTOR OR AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Site Plan Attached ^ Complete PI ns A ached LJ
Approximate Completion Date ~~~~~~~
Inspections Required and Fees
-co-<<~ ~. _~ Utilities
Sewer Tap ~'l5 C.hk-~-- Water Tap ~'I~-`~~
Sewer ~`~ ~ `'~ Water Service /~~ =- s=~~ vs
.5/ j
Septic Remote
Building
Footings ~- ~- ~ ~~~~ Drywall
~'~~'~ `~ (before finish)
Framing `~ Final /~' ~ S~~f ~
Electrical
Rough-in ~~~{vn~~l(~5" Fixtures
Final ~ ~1'1~ti~.~-- Permanent Service ~~~~ ~ 9~
Temporary Service
Mechanical s.
Rough-in ~~~E;y'/~ ~2~'c~- ABC ji'~z~`1~ l~<C~,~
Final ~~ ~-'
Plumbing
Ground Work ~`'i "tip' ~ ~
Rough-in ~~'~~ ~ ° Final ~/~~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved B
5 ~ ~
~ ~
e
BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 6 3 6 5
(402) 426-4191 Permit
Application Date:
~.~-~- a
Issue Date: ~ • 27~ S Permit Fee: $ ~ Z ~~
JOB ADDRESS I ~ \ ~ r~ r \~ I ^ r ~ ~~
YIN' V ~
V Ll/ t~
LEGAL
1 ' DESCR. LOT NO, BLK. TRACT
^ SEE ATTACHED SHEET
2 OWNER ~ r~ ~ I n ~~ MAILADDRESS ZIP PHONE
`°
l'
~I ~ ~~ ~(C i I O ~ RESS ~' I ^ / 1 ' ~x PH~ ~ ~~~ ~ ~ LICEySE NO~~
~
3. CONTRACTOR
h l t('nt/1t I/ l~ '/F°n 0(i
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: I~f~USC. ~/~C,~ri ~
]. Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
8. Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Floodplain: Floodway 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 _
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 setforth
above and in accordance with the codes~ordinances of the City of Blair and the State of
Nebraska. I derstand that this permit is void if work is not commenced within 180 days
or is not co pleted withi 2 ears of da e_of_issue. /^
S GNATURE OF OWNERfC ACTOR 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)
Framing Final
Electrical
~ ~~?
Rough-in Fixtures
Final G ° C~ 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 UR PERMIT
Comment: Approved By: /j
POUNDS PRTG: Blelr, NE ~~ Rev. 10/91
~~ PPLICATION
. BUILDING PERMIT A braska
° Jurisdiction of City of Blair, Ne
218 south 16th street 6 4 3 9
Blair, Nebraska 68008 permit
(402) 426-4191
a_
Permit Fee: $
~. ~ ~ J ~ ~ Issue Date: ~ ~ ~ ~ ~(,~
Application Date:
JOB ADDRESS ~ O ~ O ~ ! 1 `~_~1`'`~Q`'
~(((„~~ TRACT [I SEE ATTACHED SHEET
BLK.
LEGAL LOT NO. PHONE
1 • DESCR. ZIP '
MAILADDRESS
2. OWNER ~ ~~ LICENSE NO.
PHONE
MAIL ADDRESS ~ ~ ~ ~ I b /~ r~ , ~~ j _ Z~
3. CONTRALTO ~ ~~ " `'t cJ-
G
4. USE OF BUILDING REMOVE
^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^
5. Class of Work: ^ NEW
6. Describe Work:
7, Sq. FOOtage Of StfUCtUre (Including Basement and Garage):
Change of Use To:
$, Change of Use From:
g, Valuation of Work: $
Floodway Yes^ No ^
10. FIOOdplaln: Fringe Yes^ No ^
11. Current Zoning:
No^
12. State Fire Marshall Required: Yes ^
13. Special Use Permit Required: Yes ^ No ^
Dev. Permil
RFE
Elev. Cerl.
14. Variance Required: Yes ^ No ^
-Side Rear _
15. Minimum Setbacks: Front
16. Sidewalk Required: Yes^ No ^ Waiver Approved
APPLICATION ACCEPTED 8Y PLANS CHECKED 8Y APPROVED FOR ISSUANCE BY
~~_ NOTICE
Separate permits are required for elsotn~l~elbelow,gl~achnowledgelthat payment of the
tinning, and septic systems. By my g
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 setfort
above and in accordance with the codes~ordinances of the City of Blair and the State of
Nebraska. I understand that this permit is v id if work is not commenced within 180 days
or is of com within 2 years of da f issue.
DATE
SIGNATURE OF OWNERiCONTRACTOR OR AUTHORIZED AGENT
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
~ UtilitiWaterTap ~~'
Sewer Tap 7~ o0
Sewer ~ D,~ Water Service ~ ~
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final plumbing
Ground Work ~ °%
Rough-in /a ~s Final
DATE
SIGNATURE OF OWNER (IF OWNER BUILDER)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMI
Approved B~~
Comment: v
Rev. 10~B
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Safley gales, Inc.
936 20th Avenue Circle
Blair, KE 68008
City of Blair
218 South 1 bth
Blair, Nebraska 68008
402-426-4191
Fax - 402-426-4195
July 19, 1995
Dear Harland,
t has been brought to our attention., that Mr. Joe Block
I 9, 1995 for his new
contacted our office for water service on Toy date, you have not
residence at 1010 20th Avenue CircleeCtion nor has your anyone
contacted mechanical permitfforlth~~residenOe.
obtained a
nclosed you will find a copy of a letter which was -sent t.o
E 1, 1994, explaining the purpose of
and finalizing a
all contractors prior to January
the deposit -and requirements for- obtaining truction.
• n ermit. one reason for the de emodel d con lack of finals
bui l di g p
that were being requested on new and r July 28•
ou must contact our office by Friday,
Therefore, Y
to set up this .final inspection and have all permit fees pai
1995.,
or your deposit could be forfeited. m l with this and other
We-hope, in the future, you will co p Y
wilding permit requirements, and mites Y a final inspection prior
ou obtain. We sincerely
b on ALL building per
to occupancy
reciate your cooperation in this matter and hope to hear rom
app
you soon.,
Thank you.
Sincerely.
Rodney A• Storm
City Administrator
AP P LICATIOiV
BUILDING PERMIT , ebraska
Jurisdiction of Cfty of Blair, N
218 South 16th Street 6 612
Blair, Nebraska 68008 permit
(402) 426-4191
~_ '~I - c( SJ Permit Fee: $ Z r
. Z `- L~ ~ Issue Date:
Application Date:
JOB ADDRESS I f>I I,~ `~ Oy-{'~ A,,p ~~r ~ l~j
1. V L BLK. , \ V~- TRACT ^ SEE ATTACHED SHEET
LEGAL LOT NO.
1 • DESCR. ZIP PHONE.
MAIL ADDRESS
2.OWNER ~~ls- ,/~ I~ ,. I~
t~ (~i PHONE LICENSE NO.
3 CONTRACTOR MAIL ADDRESS
~~[ ~ 5ci l~ ~roLf1 K vllcx:~ ~ 2 ~ l~c~ ~ l `7 S W« n ~ ~~~~
4, USE OF BUILDING
ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
5. Class of Work: ~ NEW ^ ADDITION ^
6. Describe Work: I I V ~ ~ C ~ ~(
], Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
Change of Use To:
$, Change of Use From:
g, Valuation of Work: $
Floodway Yes^ No ^
10. Floodplain: Fringe Yes^ No ^
Dev. Permit 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 _
AC EPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY
,~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 applicatlon 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 Ciry 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 iss
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)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical ~u- CX ~
~ ^ f' Rough-in ~> , C)C~ ABC
o-, , , ~~-~~=~N~` DATE Final ~ ~ ~ ~ Plumbin
- rR~~ _ 9
~""~ ~`~" ~'^`~" Ground Work
Rough-in Final
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
Rev