BP5943~~ ~ ~ B~lILDING PERMITAPPLICATIO`iV
Jurisdiction of City of Blair, Nebraska ,
218 South 16th Street
Blair, Nebraska 68008 5 9 4 3
(402) 426-4191 Permit
Application Date: ~ ~Z ~'~ ! `~ Issue Date: ~..D' ~~ "~ ~ Permit Fee: $
JOB ADDRESS i ~~ !~ c ~ ~~ (~
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1 LEGAL
DESCR. L T N
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l3~~S ~i" TR
ACT ^ SEE ATTACHED SHEET
2. OWNER ~i ~/~ ~ I ^ 'r (~ (~ ~ ~/ MAILADDRESS ZIP PHONE
3. CONTRACTOR ~~ ~~~/~, MAILADDRESS/~ ~ /~~ PHONE
L 7 ~~(f/~~/ / C SE NO.
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~CJ~'1~ ~ ~~ ~ ( ~~ - -
7, Sq. Footage of Structure IIRdI,dIBg easement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~/~~ , 0 p
10. Floodplain: Floodway Yes ^ No ^
Fringe Yes^ No ^ Dev. Permit
BFE Elev. Cert.
11. CurrentZoning: ~C-~
12. State Fire Marshall Required: Yes ^ No[r]'
13. Special Use Permit Required: Yes ^ No [~
14. Variance Required: Yes ^ No ~~
Site Plan Attache Complete P,laJ~s Attached ^
Approximate Com a Ion Date ~ ~g"7
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes ^ No ^ Waiver Approved _
Water Service
Septic Remote
Building
BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Footings
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 applicetion 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 180 days
or is not eted wi in 2 year o date of issue. I
l0/- r
NAT RE OF OWNER/CONTRACTOR OR THORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Framing
Drywall
(before finish)
Final ~ ~" ~~ ~~
~ z 4Z Electrical
Rough-in~ d-' Fixtures
Final ~~~~~ Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Plumbing
Ground Work
Rough-in i 2.60 -hew Y~'~inal ~~ ~` ~?'"`~'~~"~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment:
POUNDS PRTG: Blair, NE / ReV. 70/91
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UTILITIES; ,
SEWER TAP:- Q SEWER ^ SEPTIC ~ WATER:TAP
^ RE,MOTE ~[~ VJATESERVICE, , ,, 1 "~ 1
e~-1:~ _ 1:J.~~~
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~ .~,. ~ ~ ~~. E ~ _ ~ s, t~
ELECTRICAL _ ~.;; -~ 3. _ ~
ROUGH IN ^ FIXTURES , ^ FINA~.
PERMANENT'SERVICE ,0 TEMPORARY SERVICE -_
MECHANICAL:
ROUGH-W ^ A/C ^ FINAL
PLUMBING";
'
~ .
GROUNDWORK ^ ...
~OUGH-IN ~Q FINAL ' .~
RESULTS OFTHEINSPECTION: PASSED(s~rrorES) ^FAILED,:~'
I
I NOTES/REMARKS:
" I
~/
• I INSPECTOR:
-
'~ DATE OF INSPECTION MADE: ~ /
. ~
'"- r CALLED OPPD\ '~
TO CONDr
~` V4~ANT OFFICE STAFF TO CALL OPPD\ . •
BCJILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Permit
b ~j oa
Application Date: ~~~ `7 /GJ~ ~ Issue Date: ~~Z~~ / ~ Permit Fee: $ 0 -~
JOB ADDRESS
LEGAL
1' DESCR. LOT N0. BLK. TRACT ^ SEE ATTACHED SHEET
2 OWNER ~ C,f/Y._J~ MAILADDRESS ZIP PHONE
3. CONTRACT R MAILADDRESS ~ } PHONE LICENSE NO.
~ ~~ ~ SLR - ~-(~~ ~
USE OF BUILDING
4.
5. Class of Work: ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~ ~'~t1~~6~,~,~
], Sq. FOOtag(? Of StrUCtUre (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10. FIOOdplaln: Floodway Yes ^ No Q 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 _
APPLICATION 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 voi if work is not commenced within 180 days
t co ple within years too ssue.
SIGNATURE OF OWNER RACTOR OR THO ZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER)
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 Permanent Service
Temporary Service
Rough-in
Final -
Plumbing
Ground Work 0,
Rough-in ~~ ' Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approv
~--.-..
Gnv 1!110
Mechanical
- ABC _
CATIO-N
6009
Nounos Nn ice: niev, ne
~IJILDING PERMITA~PPLICATIO~IV
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit 5 9 7 3
Application Date: ~ - ~ ~ °~ ~ Issue Date:
JOB ADDRESS )~~ ~~~~
/
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2 OWNER ,, / MAILADDRESS ZIP PHONE. ,
3. CONTRACTOR / r ~ MAIL DDRESS PHONE LICENSE NO.
// ~I ec~r~G ~~~' ~-~le~ ~s6~ ~~. ~la~ ~~ Dm~ha- ~~ros
USE OF BUILDING
4.
5. Class of Work: L~NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~~~ ~~ ~ ~--~y~
7. 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 ^
Fringe Yes^ No ^ Dev. Permit Elev. Cert.
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 _
APPLICATION 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 id if work is not commenced within 180 days
or ~ not co~pl tedyiithin 2 year~.a~ia of issue. ~ ~ /' ~/~~
OF OWNERjGONTRIJ~'fOR"oR AUTHORIZED AGENT
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer
Septic
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in ~~ C~ Fixtures
Final ~ • ~~ Permanent Service
Temporary Service
Rough-in
Final -
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
Permit Fee: $ ~~ - ~
Water Service
Remote
Building
Mechanical
- ABC _
POUNDS PRTG: Blalr, NE Rev. 10~B1
_~ BUILDING::~INSPECTION REPORT
~~ _ ~- -
CTTI' OF BLAIR
W
.. `~ ~ ASHIIYGTON COUNTY ~ OTHER - . .
LOCAT'IONOFINS~ECTION: _ ~ ~ E L~~i
j
~/ ~
.NAME OF OWNER:, ?"' v~:.,1 ~ ~ CONTRACTOR:
`,~~I
DATE INSPECTION REQUESTED: ~ ~S ~ ~ `~' PERMIT N0:
TIME INSPECTION REQUESTED: ('~ ~ ~- ~/
- _I
TYPE.OF INSPECTION REQUESTED:
BUILDING:
-_ j
FOOTING ~ ^ FRAMING ^ DRYWALL FIN
. AL
y
. UTILITIES; ~
SEWER TAP [~ SEWER . ^ SEPTIC
WATER TAP
D REMOTE Q WATER SERVICE ~ 1
ELECTRI .CAL: ,
' ^ ROUGH IN ~ FIXTURES ~ FINAL ~ MOTORS
Q PERMANENT SERVICE ^ TEMPORARY SERVICE
MECHANICAL: ;;'
.ROUGH-IN ^ A/C
FINAL
~ I .
. -PLUMBING:
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