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BP6889t. BUILDING PERMIT APPLI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Application Date: /~. -l~ h'~ Issue Date: Permit ~ ~' ~ g ~ 3~ Permit Fee: $ / a JOBADDRESS~/ 7 LEGAL 1 • DESCR. LOT NO. BLK. TRACT ^ SEEATTACHED3HEET 2.O .,,e C.r~ci MAI ~I 3 ~ J ~J ~ IP ~ ~2 U 0© 2S ~~~ON~ 3. CON A T R MAILADDRESS PHONE LICENSE NO. USE OF ILDIN 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: $ Floodway Yes ^ No ^ Dev. Permil 10. Floodplain: 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 acknowledge that payment of the building permitapplication fee does notconstitute 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 Inspectorand stamped 'APPROVED'. 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, is n co pleted within 2 years of the date f issuance, or if work is abandoned for six (fi) `moo hso Idn9~wh~eve Is liest. ~, ~~_ ~ _ 9~ SIGNATURE 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 ~~ D~ Rough-in Permanent Service ~~"~ ~~`~~ Final Temporary Service CATION Mechanical Rough-in ABC Final Plumbing Ground Work SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: - PDUNDS PRTG: BI9Ir, NE Rev. Oel85 r ~ ~ c r ~ v r tit ~' s' ~ ~ ~ 1 .-~ ~I (' j ~ -' Y ~F ~ I'~` ~ ~ ~ 13 4 1~ _-.' ;rs " ;'4 ~-~ c:7 ~.~ ~r r -.~ ~i ~.~: -~ ry~+~p~ r++ i~ !_yy I ti'' ~j y J~ ~ ~ `~i -Ty ~l _ •-. ~ ~ ~ , r'] ./: ~ ~~.~ f. `tXl ~ "`~.~ fx1 i^-; `~ •-~ ~~M W ~~ t ~., 4~ ~ ~~, i ~ ~, ~ /~ ~S y J "'i 4 4'pw ~{ '.~ r~, 'a=°I ~3 C17 8 ~~ i3 ;• [~ ~ Q ~ ~ r '~~ ~ ° ~ ~~ f A ~ { y~ Y? ~ ~ ~ !~.-~ L.J ~;~ ~~ ~ t,~; 4--J 6. ~ ~ 1..:..J Y^~ ~.-D ['lj x ~ r K "" ~ ,1 ~,,: ~ `t (.; 4 ~, ~ ~ . ( ~~„ ~ f ~....5 q F-- ~ ~F~ Y•i rr 4~ ~: ~ C`~ c~ ~; tc~ W 4-~%- ~ °~yy¢ A ..... ~ jE`~~~: r `~~ .C~. Cs`i CJ 1 ?-~ m j~y~ ~~: ~ ~` ~-~5 '~"! it` a C7 ~J tee' ~_ >~ 'd ~ y L.~~iy+ ~ ~ ~ ~ 4. " ~ }R~ y~ ! ~ ~ ~.w~ t~^yp ~y~. M,i Sr@'~ A~ a ~ y~..~ i.r n ~: ~ ^ {.....! ~ ~~ ~ ~~ .`.9 r 4~ ti~ !'s ~ ~~, p o r~ ~, ~ ~ ~ ~< r~y ~ ~ ~ ?p+y5 '~/ a ~S ~ ~~ '~y ~ 5 1 d` {' ~ ~- C, 1 t ~ i 4 ~ ¢j ~ ~~ ~ ~ ~.1 ~ ~ . -3 "~~ ~ ~,. '~ 4~ ~. V ~ ~~ ~ ~ L,.j i (Ty ~~ n ~ r~ ~ ,,.,~, ~ .~w ~ ,ri]'1"IT J V ~ ~ 't~ ~ ~. YfY ~ ~ 4' ~. 'J~ C' ~ u ; ~*; ~~ ~ '~' ^ Mrt $ I } ~: f ~ I i ``\ ~ 3 t !r ~ ~ ~ I ,. ~~ _ R ~ p y ~. ': ' ~~j$ W ~...~ t~J ~ ~ .. f 9 E ~' i e~