BP6156BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska Red cK/~0?~doCl ~'
218 S uth 16th Street
`~/3/~s-
° 6156
Blair, Nebraska 68008
(402) 426-4191 Permit
Application Date: ~ (~ ' 2.7 `~l ~~ Issue Date: 1 ~' Z'i`t Permit Fee: $ ~~~ ~~~
JOBADDRESS n n `
I ~ ~ 4'~t J Q~ U'~~~ ~_J f L~S~-
LEGAL
1 ' DESCR. LOT NO.
' ~ BLK. I TRACT
~lF~ t~C ~~ ^ SEE ATTACHED SHEET
2. OWNER MAILADDRESS ~ ZIP PHONE
~~ n cz r~d l~-o r~ ~' 1
3. CONTRAC/~R MAILAD/D?RESS ~ `C~(~ ONE ~e~/ -J ^ ~ ~ (/~~
USE OF BUILDING
4.
5. Class of Work: KNEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ C(~ e / ~ U ~ ~ ~' ~ .
7. Sq. Footage Of StrUCture (Including Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~ j, Cab C~ , UC ~
Floodway Yes ^ No Dev. Permit
10. Floodplain: Fringe Yes^ No per" 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 _
eY 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 Ciry 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 c leted within 2 ye s-of-dat Issue.
OF OWNERfCONTRACTOR OR AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER)
DATE
Site Plan Attached ^ Complete Plans Attache
Approximate Completion Date ~ -~ ~~ ~-1
I s ections Re uired and Fees
/ 2rZ~f ~ P Utilie s
Sewer Tap t~"7 ~_ U(~ ~CGG~1 Water Tap ~2 2~`I `~
Sewer ~ ~~" ~ ~`~~"~` Water Service ~~~'~ ~`~CGC~li
Septic ~1 Remote
~~ Building
Footings '-gyp - I I ~~`~ Drywall
(before finish)
Framing ~ `2 ~'~ ~ Final ~ ~'"~ ~"~~~_
3-v~/-9S
~ _~,~ _y •~ Electrical
Rough-in ~ rG~~- ~ ~ `~''<~ Fixtures
Final / '~ Permanent Service >~
Temporary Service ~~-~~ S
~~~..~`(~ Mechanical -mc~-~ ~'• ~~l u.~w~-cal
Rough-in ~~ ~l~i7r~~ ABC ~s~~-l -~~1~~~
Final ~./ ~,
I~ZU-9~ Plumbing -, `
Ground Work's a Lei ~5 I
Rough-in / /7_~ CO ~'~`~ Final- / ~- C`~) ~~~~~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
-~~C1o.c3O ~i~~oy
Comment: Approved y: e-
"I
s
BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit_
Application Date: ~ Z ~ I - ~ ~~ Issue Date: ! 2- ~ r ~ ~ Permit Fee: $ ~ ~~ -~~(~
JOB ADDRESS
III R,i ~ ~~ ~'t~J
~ ~ .
1 . LEGAL
DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHEp SHEET
2. OWNER /\~+ K. ~C~ /~(n
+
K
. MAILADDRESS Zlp PHONE
~) /~' n ~ ~ i r ~~~
`
~
3. CONTRACTOR
}I-'t IL~J MAIL AD~RESS~~ ~~~ I k~ PHONE ~ ~ ~ ` ~ C/ LICENSE No.
N C-L)
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: f ~1~ ~ ~
], Sq. FOOtage Of StrUCture (Including Basement and Garage):
$. Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes^ No ^
10. Floodplain: FriRgB Yes^ No ^ Dev.Permit
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 its 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 agreeto perform the proposed work in accorda a with the specifications setforth
above and in accordance with the codes~ordinance f the~i it and the State of
Nebrask . I understand that this permit is void if k is no commen ed within 180 days
or I of co pleted within 2 years ofd e o e. / ~
DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap 7S • a~~ Water Tap
Sewer ~ ~• ~~ Water Service ~ ~ •
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
~
h
i Mechanical
oug
-
n ABC
Final
// ~/`~ ~/ Plumbing
~/ Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in I ~• C) ~~ Final
(~.c~c>
WHEN PROPERLY VALIDATED (IN THIS SPACE) THI S YOUR PERMIT
Comment: Approved By: /~
6.216
POUNDS PRTG: BIeIr, NE ~~ Rev. 10)B1
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~ - ~o ` ~ ~ Issue Da#t3:_
Permit
6296
Permit Fee: $ i~ •~(~
JOB ADDRESS I I ( ~I v~
V ~
J ~~
1
ti
r
LEGAL
1 LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
• DESCR.
2 OWNER ~1 MAILADDRESS ZIP
~j 1~(r~~. / r 'v~~ PHONE
3. CONTRACTOR ~ -~ Unl ~~~ N ~ nC' ~MAIAI 1. ESSy,~Z1~ 5 , ~~~ S/ PHONI~CL~ ICS L~~~ ~7 L~ % ~o7,SC~C~\~
USE OF BUILDING
4.
5. Class of Work: ~ NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: OU~~ ~ ~~,rl ~ ~ ~~ ~,
7. Sq. FOOtage Of StrUClUre (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
lain: FI°oaway Yes ^ No ^ Dev. Permit Elev
Cert
10
Flood
.
.
.
p
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 ^ Complete Plans Attached ^
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
Building
BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
l 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 codesJordinances 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 wit ' 2 years of date of issue.
Z-~- clS'-
CATION
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
` Mechanical ~ l
- off- Rough-in C~ • ~' U ABC 1 C' ~ (~ C }
~T ,- ~ DATE Final Cv - ~' <_'
~~._.
-- = 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:
e r!~'~
FUNDS PRTG: Blalr, NE Rev. fOJI
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date:
~ ~'~ ~ ~ Issue Date:
217- ~5~
CATION
Permit 6 3 2 2
Permit Fee: $ ~ ~ -~ (~
JOB ADDRESS '
1 , LEGAL
DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET
2, OWNER . ~ 11 MAILADDRESS ZIP PHONE
Cl(~~1~y ~~ I )~
3, CONTRACTOR ~ C~ I ~ 1 ~~v J11~ l I V ~AILAD_DRESS ~ I\ `~ ~~L)~( / ~ P~~~~)~ Ln C ~~ (J~~U ~NSE NO.
1 ~~ V
USE OF BUILDING
4.
5, Class of Work: ~ NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: I Tc,U~`(" y,~~~~~-r, C G~
], 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 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. Sidev~alk Required: Yes ^ No ^ Waiver Approved _
BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
NOTICE
Separa a 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 Inspectorand 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
N raska. I understand that this permit is void if work is not commenced within 180 days
or is of co p~eted within 2 years of date of issue
SIGNATURE OF OWNER)CON~A TOR 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 ~•UC~ Fixtures
Final ~~ ~ X a Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS,.IS SOUR PERMIT
Comment: Approved By: ~ ~
;'~
POUNDS PRTG: BIeIr, NE ~ ~ ` Rev. 10/91
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