BP5638~~ r BUILDING P~RIiIIIT APPLICATIO~iV
Jurisdiction of City of Blair, Nebraska
" 218 South 16th Street 5 6 3 8
Blair, Nebraska 68008
(402) 426-4191 Permit
Application Date: ~~ - ~ ~ ~~~ Issue Date: ~ ~ r3U ~ Permit Fee: $ %aG~ - 6(~
JOB ADDRESS
~C>~ "~ ~ }' 12w--~
Il ~0~y
LEGAL
1 ' DESCR. LOT NO.
6 c BLK• TRAC~~ ~~~ ~ ~~ ~~~ ^ SEE ATTACHED SHEET
2. OWNER ~~ r Lam- MAILADDRESS ZIP PHONE
CONTRACTOR MAILADDRESS PHONE LICENSE NO.
s. v~~cz r~'. ~i~ Cc~~~-fir ~ ~~, 6 r ~ ~ I I ~~ ~ ~e~~ 0 r~. ~t z ~ •~~~ ~~
4. USE OF BUILDING
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~
7, Sq. Footage of Structure tmduaing Basement and Garage): ~`~ (~ _ ~,~5~_
$, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~ 7~ Cj ~ , (~~
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 2S Side 2 Rear 2=
16. Sidewalk Required: Yes® No ^ Waiver Approved
APP~I TION ACQEPTED BYBY PLANS CHECKED BY 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 acknowledge 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 nderstand that this p rmit is void if work is not commenced within 180 days
or is not w leted withi years f date of issu~
~ ~~~-~~~ ,tee ,~
I NATURE OF OWNERf CONTRACTOR OR AUTHO jIZ D AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE
Site Plan Attached Corr~plete Plans. Attached
Approximate Com etl n Date/~ -~-~- ~ . ~ ~~ ,
Inspections Required and Fees
Utilities
Sewer Tap'~"1~ (~ fee-/ Water Tap '~
. Sewer ~' i ~~'~~~ ~~ ~ `~ Water Service ~~c.>-~
Septic Remote
f~u,rd ~-
Building
Footings' Drywall ~
(before finish)
Framing c.~' ~" (2 ~ ~ Final 4~ ~r~"~cl r~
~~2-_S-~/~/
~ (2~i~-I Electrical ~~~6-yUj
Rough-in /QI ~ EIS c~-~-rxtures
Final ~/ rv~ Permanent Service ~/' ~ ~
Temporary Service
~~ ~ Z.,ct~ Mechanical
Rough-in ~ c% , ~5t-`c . ABC ~~l ~c/LrSlf
Final e~ ` `` `"
~ ~-(Z,~, y Plumbing
Ground Work `
Rough-in el 12.od ~ P~-•-„ Final ~ ~ ~ ~ ~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Appro d B • -~ ~
SOUNDS PRT6 -Rlelr- NE Rwv. 7fVG
CITY INSPECTION SLIPS
.Inspection has been requ sted for ~~,~- ~(~ ~-f-~/~~1'~1.~C~-~~~v-S J ~c~
~D ~ ~~~ Location of Building
\ ~ ,/ /~
N` a'me o f Comp any
Type of Inspection
At ~-ZZ ~i3 1~-CCU
Date Time
Results of the Inspection are:~~~
C ty Representative
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BUILDING P~RMITAPPLICATIO~IV
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
Application Date: I ~ ~? ` C~ ~~ Issue Date: / - .a ' ~~ ~ Permit Fee: $ ~ Z ~
JOB ADDRESS
G~ b ~
~ ~~c~
r c~.~
LEGAL
1' DESCR, LOT NO. BLK. TRACT
^ SEEATTACHEDSHEEr
2. OWNER MAILADDRESS ZIP PHONE
r3. CONTRACTOR
1 ~~~ (( ~(~ MAILADDRESS PHONE LICENSE NO.
~ l ~ L I Ifs (~ ( -
'
4. USE OF BUILDING
5. Class of Work: NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~C,11~~' ~ ~.~eC~~L
7. Sq. Footage of Structure (Induaing easement end Gerege):
8. Change of Use From: Change of Use To:
g, Valuation of Work: $
10. FIOOdplaln: Floodway Yes ^
Fringe Yes^ No ^
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 _
~~
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 acxordance with the codes~ordinances of the City of Blair and the State of
Ne ask . I understand that this permit is void if work is not commenced within 180 days
Is n~completed wit in 2 years of date of issue.
i
OF OWNERfCONTRACTOR 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 C~~ ~~ Fixtures
Final ~~• GC% Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Ground Work Plumbing
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE ROUgh-In Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
G[,~,,! Gtr
5682
POUNDS PRTO: BIaIr, NE Rev. 10/91
BUILDING PERMIT APPLI
Jurisdiction of City of Blair, Nebraska
' 218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
CATIO~IV
Permit 5 7 6 3
Application Date: ~~ - ~~-- ! ~.I Issue Date: ~ ~ l S" ~`~ Permit Fee: $ ~( .C~C~
JOB ADDRESS
~~
~ 1 ~ ,.
~ W ~.
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2. OWNER ~/
~~/ r M MAILADDRESS ZIP PHONE
~.~~~`~
3. CONTRACTOR MAILADDRESS PHONE LICENSE NO.
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):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Flood lain: Flooaway Yes^
p Fringe Yes^ No ^
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 _
8Y 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 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 180 days
or is not completed within,2y~ars of date of issue.
SIGNATURE OF OWN~R~QFITRACT01~ Oji AUTHORIZED AGENT DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Sewer Tap 7 s. y~ UtilitiWater Ta
p
Sewer «~' ~ Water Service ~ ~ , 6
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
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in ~ 2 ` vU Final ~~ ~ p
WHEN PROPERLY VALIDATED (IN THIS SPACE) THI S OUR PERMIT
Comment: Approved By:
P
POUNDS PRTG: BIeIG NE ~ j ~ Rev. 1091
,_
BUILDING P~R~IgIIIT Ai~PLICATIO~N
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
q ~ o,
Application Date: ~~ ° ~ ~ '~ I ~ ~ Issue Date: ~r~2 % L/ Permit Fee: $ 22 '~ ~>
JOB ADDRESS ~ O `~ ` ~~ ~~n^ \ I ^ r
' r `.J CI/ /I
~`-
LEGAL
1' DESCR. LOT NO. BLK. TRACT
^ SEEATTACHEDSHEET
2, OWNER MAILADDRESS ZIP
L .rn N~,~.~'1 ~~ PHONE
3, CONTRACTOR MAILADDRESS PHONE LICENSE NO.
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: Z,Z~ ~~~ ~ c ~~~
], 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 ^ 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 _
BY 1 PLANS CHECKED BY 1 APPROVED FOR ISSUANCE BY
NOTICE
Sepa to 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 copyof this application form signed bythe 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
N raska. I understand that this permit is void if work is not commenced within 180 days
o'I not corgplelec~ w~hin~ years of date of issue.
NATURE OF OWNERICONTRACT{~R 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 Permanent Service
Temporary Service
~ • ~~~ Mechanical /~, ~ _ 1
/ V
Rough-in q~C
Final ~ Uc ~
Plumbing
Ground Work
-SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough-In Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS YOUR PERMIT
Comment: Approved By: ~ /
i ~_
5864
POUNDS PRTG: Blelr, NE // Rev. 10/91
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