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BP5396BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Permit 5396 ~~ c= C_^ Application Date: ~~ Issue Date: _ ~ J ~ ~ Permit Fee: $ (-~~ JOB ADDRESS ~ _ %~~-I V y' I I 1 LEGAL LOT NO. ~ B L K TR 1i l~ / ~ SEE ATTACHED SHEET DESCR. ( ~ 2, OWNE .htAll DDRESS / ~- ~j ~ ~ Zl~f ~ J~~PWONE J 3. CONTRA 0 MAILADDRESS PHONE LICENSE NO. USE F BUILDING 4. ~ ~~, 5. Class of Work: NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6, Describe Work: , 7. Sq. FOOtage Of StrUCture (Including Basement and Garage): ~~ ~ a 8, Change of Use From: Change of Use To: g, Valuation of Work: $ ~ ~ ~~ ~ ~~ Floodway Yes ^ 10 Flood lain: No ^ Dev. Permit EIev Cert. . p FrlRge Yes^ No ^ BFE . 11. Current Zoning: ~ (-- 12. State Fire Marshall Required: Yes ^ Nom 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 by the Building Inspector and stamped 'APPROVED'. I hereby agree to perform the proposed work in accordance with the spe~I ' lions set forth above and in accordance with the codes~ordinances of the City of fair a d the State of Nebrask~l understand that this permit is void if work is not com ence ithin 180 days or is nok mpleted within 2N~;irs..n~date of issue. OF OWNERICONTRAC70R OR AUTHORIZED AGENT DATE SIGNATURE OF OWNER (IF OWNER BUILDER) Site Plan Attached Comple~ PI ns ~a~ d~ Approximate Com letion Date Inspections Required and Fees Utilities ~ Sewer Tap Water Tap Sewer Water Service '~ 1 ~ •~~ ~"~-~ Septic / I ~ ~ ~~ ' I'~m,~ Remote G,,,~~3 Building Footings '~~° (~'~ ' C~ Drywall °~ (before finish) Framing ~ Final ~~."~~~ ~~ Electri ~ li "~~ /a ~u -~~ Rough-in ~Fixtu s Final r/ ~ ~ ° ~~ Permanent Service Temporary Service Mechanical Rough-in /L~.CY~ - (~'~ S ABC / /O C~C~- ~~S Final ~ Lo . c`~~ `~ Plumbing Ground Worker + Rough-in ~ 12--y0 ` ~1~ Final +~ lo• nC~ - Lin .s DATE WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approv ~~%~~ ~. 'OUNOS PRTG: Blelr, NE Rev. 10/B BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska. 219 South 16th Street Blair, Nebraska 68008 5 4 2 (402) 426-4191 Permit Application Date: a~(~ r~ Issue Date: ~ _ ~ ~ Permit Fee: $ ~~~V JOB ADDRESS LEGAL 1 ' DESCR. LOT NO. g f BLK. TRACT ~,R~~ ('~~ ^ SEE ATTACHED SHEET 2. OWNER C~~ Z~ CM/A¢ADDRESS ZIP PHONE 3 CONTRACTOR ,r~ I / ~ MAIL ADDRESS IJl C~r~ ~1'PC~21 ~ HONE LICENSE NO. ~ ~J~ ~ '~ USE OF BUILDING 4. 5. Class of Work: NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~.~ -e 7. Sq. Footage of Structure (IRdudiRg BasamaRt and Garaga): 8, Change of Use From: Change of Use To: g, Valuation of Work: $ Floodway Yes ^ No ^ Dev. Permit 10. Floodplain: Fringe Yes^ No ^ BFE EIev.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 I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY NOTICE Separate per is 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 OF OWNER~CONTRACTOR OR AUTHORIZED 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 ~ CXl Fixtures Final ~ Ck) Permanent Service Temporary Service Mechanical Rough-in ABC Final Ground Work Plumbing Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved y: SOUNDS PRTG: Blelr, NE R~Y• ~~~ BUILDING PERMIT APPLI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Septic 14 ~ ~~ Remote Application Date: g'2~~ ` 1.> Issue Date: ~ ~~~ Permit Fee: $ ~p~ ~~> JOB ADDRESS ~~'0~1 ~~ay~S 1 . LEGAL DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET OWNER MAIL ADDRESS ZIP 2. ~ ~~ e,rJ cJL PHONE 3. CONTRACTOR ~a ~ ~ ~ 1eC~(C ~ ~~~ LADDRESS ~ ~` ~Q X /r PHONE) V 1`~ ~~~L /~ ~j~~ / ~jLICENSE N0. 7 [~ i '"'' ~ f~ O U~~ z ~l ~~ /~ 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 Gerage): $, Change of Use From: Change of Use To: g, Valuation of Work: $ 10. Floodplain: FIDDaway Yes^ No ^ Dev.Permit Fringe Yes^ No ^ BFE EIev.Cert. 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 Water Service ~ ~ . C~~ 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 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 of cb leted within 2 y~rs of date of issue. E ~~...- G ATURE OF OWNERJCONTRACTOR OR AUTHORIZED AGENT DATE Building Footings Drywall - (before finish) Framing 5505 Permit Final Electrical Rough-in Fixtures Final Permanent Service Temporary Service Mechanical Rough-in G~•C~O ABC ~4.CX~ Final ~- ~~ ~ Plumbing Ground Work SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in I ~ • CSC) Final ~ `~ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT CATION POUNDS PRTG: Blalr, NE ~ Rev. 10/81 CITY INSPECTION SLIPS i": J7 JO ~~~~5 j~~ Inspection has been requested for~U~ ` Location of Building y //`lt. ~ N of Comp~a~nyT7 " On l ~ ~it~l {~ • ' y e of In pection At ~~~,~ ~ ~~ ~ . Da a Time Results of the Inspection are: ~/ /~ Ci y Representative ' CITY INSPECTION SLIPS Inspection -has been requesCed for '--~JQ~ Location of Building • By u!~~~2.u.~ ~ ' ,,N/ame/ o,.f C~omp~,any Type of Inspection ~t G ~ l~ ~l3 Date - Time Results of the Inspection are: ~~~ / +! 1~1-- y Representative CITY INSPECTION SLIPS Inspection has been requested for ~~-~~-¢. ~~ Location of Building By~ ~_t. Name of C mpany r On _ ~a t-~-t Type of Inspection ' nt ~) ~/ ~ ate Time / Results of the Inspection are: ~ !/1 Cit ~Rep~ ntative in - a .-. N O F- U W N Z H r-t O w > v H N U N a HC W ~ N A ~ 0 .~ w H z" ~~ w ~ ~r~1 u ~ o q .,~~ ~ td u \ Y w ~ a ~ a° n ~ ~ ~ o r~ Y 1 ri V H F- v W ~ d Z N rt ~ N H W ~ f1 H u ttl ~ U N ~~ ~ ~ tltl U N ~ y N ~ V H ~ ~ q P. yy N ~ w r~i 'O -~ o ~ O1 .G ,p g ~ 6 z ~ ~a v o .,°i ' `ro u ~ ~ ~ ~ a °v~ - ~ ra 2 .-__.-~ -,--~n_-,r-. T ..rte-Tr- i ~ ~~ f _ 5. 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