Loading...
BP6116, .. BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Stree# Blair, Nebraska 68008 6116 (402) 426-4191 Permit 9 ~9 Application Date: Issue Date: Permit Fee: $ JOB ADDRESS ~~~ 1 LEGAL LOT NO, BLK. TRACT ^ SEE ATTACHED SHEET . DESCR. OWNER 2 `~ MAIL ADDRESS ZIP ~~~~ ~~ PHONE- ~ r , / ~ ~ ` 7 7 CONTRA R 3 ~ M LIC SENO~ ILADDRES - PHONE , 'd USE OF BUILDING 4. 5. Class of Work: ^ NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ], Sq. FOOtage Of StrUCtUre (Including Basement and Garage): 8, Change of Use From: Change of Use To: g, Valuation of Work: $ FIOOdplaln; Floodway Yes^ 10 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 _ Site Plan Attached ^ Comp~e~Cans At~h/e~: ^ Approximate Completion Date ~J ~I~~Y Inspections Required and Fees Utilities Sewer Tap Water Tap Sewer Water Service Septic Remote Building 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 void if work is not commenced within 180 days or is no{t~ompceted wit i 2 ye/~rs of date of issue. SIGNATURE OF OWNER~CONTRACTOR OR AUTHORIZED AGENT DATE Footings Drywall (before finish) Framing Final ~ ~~'~ ~ `~~--f Electrical Rough-in Fixtures Final Permanent Service Temporary Service Mechanical Rough-in ABC _ Final Plumbing Ground Work SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPP~6Ej-~#lS~ IS YOUR PERMIT Comment: Approved~y: ~, _ '71 POU-7NOS PRTG: Blelr, NE Rev. 10/91 ~/ ,~ •J d Cx`b'~r C73 `I3r.alit ~ I~rLSTTIs~`CY1'C}?~' ~'C~I3''7`~i' ~~ {~'1"rT~ft_a,~.~. _______~ - ., f •" j i 5p ._..... _..-- _.-__ _z ,~-.. ..,..-,.,,.,----_....,.. _ [ ~ ; ~(.e 7~ y~ *~ I~~417C)C~t)ti4'T,'EFi:~ _ ~-t_t'_J id;_ ~C?~"IftAC/'r`(1k _.~,~'"` I'~ f _ I7.~1T1:~1NSi'T°:C;'1'rC)Nl{E T,r~S'Ff?li.._,~ ~~ ~~°~ I'EI~~tIT`NC?._~.-- ~-~#sf------ { _ _ °rrlv~> t~sT~ryc~rrca~r ~r~r~u~~T•rr~: __.. _ n__.,.~. ~~ ~,~~ ~-~I .,. T 'i`YPF: ~r~` ICtiSI'F~1'IC)N T~r:Q(II:~'1`FTf: _F. 7~y~{P ~r*~ p _ may; .(; T~{/~ T p~ ~i~A 7 i +.E r ~ ~~{, ~~ t=f1'\~I1i~54P ~~!'tLti<Y~ll'~l.-.P ~~ I~t1~Tt f~.~.~~y ~1~~A 1,: 4 ~ ~ f u~rrr,tr-~T~~~: ~;E1ti~i'7~ T~1' ~ .f SCl4'~[t ~~ ~Iif}'f1C'. (~ 1~1f~'I`I:I~ Trll' ©-~~~t~~e ~ ~~=~T~clr srr~r~rc; r1r,~~~r~zrC;~t,~ F. u~~urra rr~ ~ rrx~rl.Il~~~ ~ r~i~~r. (~ ~~r~~r•c,Ks I'T~Izl~ral~EN'1 ~;E'It~'(C`T ~ T~~1C'()u.~l~~' ~E:uS;I(' h1k~f,~~f~T1't~'r1~l~t . r;r~I~~t~tr~c;: [': i 1 ~ C;;Itt)(al~~r)~'~3T~K ~ uC~UC;Ir-I;~ ~ F[N~II~ ur~~TII.TS()r°'I'HII~S!'F~"I'IC)~. ~PrA~~L;I~jS4~S~t~fiExS [~I~ALEI)ts[taE:tErr~:~} F *~pp( +~±c y di\~ 1 L'.7111r;Y1J'1~~1t.~i`. ~,., I",t~I~EiC'Tt~T~: l)ATFs ~T= rTv'~r'F~'TTC)~.7 I~•t1~[~T~:~'~ ~.' ...,.~__ `Cih`(Iti: ~.~,~ ~AI_i,k:r) f~I'1'1~ _.n .:v.y_,~~ 'fC) Cf3~'~r;~,'T ~IiktYrCryF. [_~ Y~fi [~;~i() i S Wn'~~T(3T'IIC;f~~7',~(I7`C~C'-11.I,(7I'C~1)\,._ ,..._--- ~YI>~ ~C) r3l,Rl ~-