BP5656-~ ~ BUILDING PERMIT APPLICATIO~1
` ~ ~ Jurisdiction of City of Blair, Nebraska
218 South 16th Street
' Blair, Nebraska 68008 5 6 5 6
(402) 426-4191 Permit
Application Date: ~ L'~' ~ ~ ~~-~ Issue Date: ~ Z ° ~ ' ~~~ Permit Fee: $ ~~6 .6C~
JOB ADDRESS ~ ` ~~Q~.
LEGAL
1 • DESCR. LOT NO. ~ ~
~' BLK. TRACT
~ ~ I~ ~='r"
(`-
^ SEE ATTACHED SHEET
2. OWNER f --- MAILADDRESS
~~fT' ~ f Zlp PHONE
CONTRAC R ~ MAILADDRESS PHONE LICENSE NO.
USE OF BUILDI G
4. ~-(~~~ 1g5 ~. ~ ( Y'1 ~
fir, z
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~1~, ~ TU ~~5~~
]. Sq. FOOtage Of StfUCtUre (Including Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $ C~ b J~~~~ O ~
Floodway Yes^ No ^ Dev.Permit
10. Floodplain: Fringe Yes^ No ^ BFE
EIev.Cert.
11. Current Zoning: -~~ 1^'~
12. State Fire Marshall Required: Yes ^ No[~
13. Special Use Permit Required: Yes ^ No ~
14. Variance Required: Yes^ No0/
15. Minimum Setbacks: Front ~SsSide 2 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 permitapplication 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'.
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 ~ ~1 ~
Inspections Required and Fees
~'(?~ `t ~ lities
Se~ver~an ~ ~ ~ Ck1 G^k ~~ Water Tap ~
Sewer ~~~ Water Service ~ /~+ •~ <J
Septic Remote
~Vc~.
Building
Footings ~~- ~~" c~v Drywall `~~ ~~~
(before finish)
Framing~~°~(~`~ Final r~ ~ ~~~I
Electrical
'I -1 I
Rough-in ~I~C~+u t- Fixtures
Final ,L i / Permanent Service ~ ~~~
Temporary Service
• ~~ l'~ `~ Mechanical ~ ~
Rough-iri /~ -~ e(~r~~ q~C ./ ~.~ I y~~.156v,~
Final ~~ ~ ~~ ~- ~'`~-
Ground Work~S°~~"~`~Plumbing
,~i(x Fehr
Rough-in _J~2 • ~5 ~ /t~ Fina~ ~ ~. C,c~ - C%in;~G--~~ t
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
POUNDS PRTG: Blair, NE /v Rev. 1x91
17 : ~fi F-AX 4Ef2 33~f 5368
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.. _ I ..
. BUILDING PERMITAPPLI
Jurisdicti #-Gtt~--of-B~a+r-~I~ra~ka
218 South 16th Street ~
Blair, Nebraska 68008
CATION
5679
Permit
Application Date: ~~ °~7 ~ ~ Issue Date: ~ ~-'2~ ~~ ~ Permit Fee: $ /-3. ~
JOB ADDRESS r ~
C1 ~~ V ~~ ~ „ ~ B
C-- C%r~ l J ~-'I-~_
LEGAL
1' DESCR. LOT NO
~~ BLK. TRACT /~
/ ~ ~~
/ ^ SEEATTACHEDSHEET
2. OWNER ~r ~, MAIL ADDRESS
f ~ C~ ZIP PHONE
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
USE OF BUILDING
4.
5. Class of Work: C~NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: C~l~ j-~ _ P( c YV a~~ ~ ~,~
7. Sq. Footage of Structure (IndDaing Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~
10. Floodplain: Floodway Yes^
Fringe Yes^ No ^ Dev. Permit
No ^ BFE Elev. Cert.
'"'1
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
eaal Irerin_u errocrcn,ay_ - pLANS CHECKEe ^'~ Apppn-~~ ~"^ ~saUANCE BY
,=
Site Plan Attached ^ Complete Plans Attached ~]
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Tap ~-~' U~ Water Tap
Sewer ~ a • O ~ Water Service ~~ • ~ ~
Septic Remote
Building
roonngs urywau
(before finish)
Framing Final
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 bythe Building Inspector and stamped
'APPROVED'.
I hereby agree to perform the proposed work in accordance with the specifications setfort
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 t complete withi 2 ye rs of date of issue. ~' ~3
Electrical
Rough-in Fixtures
Final Permanent Service ~-
Temporary Service
Mechanical
~ 7/ Rough-in A\C
-SIO' TUREOFOWMER)CONTRAOTOR6 UTHORIZEDAGENT_ ? DATE Final plumbing
Ground Work ~ ~d
Rough-in ~ ' c~U Final
DATE
SIGNATURE OF OWNER (IF OWNER BUILDER)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS I YOUR PERMI
Approved By: ~: ~A •,,
Comment:
POUNDS PRT6: Blair, NE
BUILDI~I~C PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street 5 8 6 8
' Blair, Nebraska 68008
(402) 426-4191 Permit
Application Date: 5- ~ L" 1 ~ Issue Date:
Permit Fee: $ ~-
JOB ADDRESS , L ~ ~ ~~ /
LEGAL
1• DESCR. LOT NQ BLK. TRACT
^ SEE ATTACHEDSHEEr
2 OWNER I ~ f ~ ~ MAIL ADDRESS ZIP PHONE
1•
~~ ~ ~e I~~ ~~~1~ ~ ADDHES~ /~ PHONE LICENSE NO.
3 CONTRACTOR
11-GIJ $L~3 -~e>7r/ OmCi~l
USE OF BUILDING
4.
N ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
5. Class of Work: NEW ^ ADDITIO
/
6. Describe Work: ~ ~ ~y-~,~J C C
], SQ. FOOtage Of StfUClUre (Induding Besemenland Geiage):
6. Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Floodplain• FlaadwRy Yes^ No ^ Dev. Pe~mil
' Fringe Yes^ No ^ BFE Elev. Ced.
11. Current Zoning:
12. State Fire Marshall Required: Yes ^ No^
13. Special Use Permit Required: Yes ^ No ^
14. Variance Required: Yes Nod
15. Minimum Setbacks: Front Side Rear
16. Sidewalk Required: Yes ^ No ^ Waiver Approved _
APPUC TION ACCEPiEO BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
~~~~/
NOTICE
Separate permits ere required for electrical, plumbing, heating, ventilating and air condi-
goning, end 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 lurther
agree that conslrucgon covered by this permit application shall not be commenced until I
have received acopyoi Ihis application loan signed bythe Building Inspectorand stamped
'APPROVED'.
I herebyagree to perlorm the proposed workin accordance with the specilications set forth
above end In accordance with the cedesfordlnances of the Clty or Blair and tha State of
Nebraska. I understand that this permit is void if work is not commenced within 18D days
or is not completed within 2 years of date of Issue.
SIONATUREOFOWNERICONTRACTORORAUTHORIZEDAGENi 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
(belore finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
dC~
l~)
Rough-In ~• OCR •
q~C
Final /~• UO
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE ~ Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS I YOUR PERMIT
Comment: Approved By:
-l // i //
PouNns PRTO: Blee, NE
~I~~~~ ~t ~~ "~
-{ fie. f~.~-til, ~h--~e ~J n-r>`e~
' U ~> r~ ,
~h~n X`~ .
Rev. 1g91
`~ BUILDING PERMITApPLICATIO~iV
' `Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit
5947
Application Date: ~ `~~ r / ~ Issue Date: ~"~~ ~~ Permit Fee: $ ~2 d(~
JOB ADDRESS ~~ /'~r_ _ _ /'
LEGAL
1 LOT NO. ~ BLK. TRACT ~/y ^ SEE ATTACHED SHEET
' DESCR. V~
2. OWNER AILA DRESS
~ ~s P. ~2 ZIP PHONE
.3. CONTRALTO ~~ ~I` C.~ ~, VOO~DRESS ~T~~~~~ PH!-/l CJO~r~~ (~75 E/ Lf~6
USE OF BUILDING
4.
5. Class of Work: NEW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~~ ~ ~~ C~.~L~
], Sq. Footage Of StrUCtUre (Including Basement and Garage):
8. Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Floodplain: Fl°Ddway Yes ^ No ^ Dev. Permit
^ No ^ BFE
F
i
Y Elev. Cert.
nge
r
es
11. Current Zoning: Site Plan Attached ^ Complete Plans Attached ^
12. State Fire Marshall Required: Yes ^ No^ Approximate Completion Date
Inspections Required and Fees
13. Special Use Permit Required: Yes ^ No ^ Utilities
Sewer Tap Water Tap
14. Variance Required: Yes ^ No ^ Sewer Water Service
15. Minimum Setbacks: Front Side Rear septic Remote
16. Sidewalk Required: Yes^ No ^ Waiver Approved Building
APPLIC ON AC PTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Footings Drywall
(before finish)
NOTICE Framing Final
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 EleCtriCal
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 Rough-In -~ Fixtures
have received a copy of this application form signed by the Building Inspector and stamped
'APPROVED'. Final Permanent Service
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
Temporary Service
Nebraska. I understand that this permit is void if work is not commenced within 1 SO days
or is not completed within 2 years of date of issue. Mechanical
_ Rough-in ABC
SIGNA RE OF OWNER/CONTRAGTOH OR AUTHORIZED AGENT DATE Final
,y ` /~~ p~s ~~
~/ ..,~ ~ J ~'
Ground Work Plumbing
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) TH S YOUR PERMIT
Comment: Approved By ~~
POUNDS PRTG: Bleb, NE / / Rev. 10191
BUILDING ~PERMITApPLICATION
_ _ Jurisdiction of City of Blair, Nebraska
' ~ 218 South 16th Street 5 8 6 8
Blair, Nebraska 68008
(402) 426-4191 Permit
Application Date: ~` ~ L ` ~ `~-I Issue Date: ~ ! ~ ~ " f ~~ Permit Fee: $ ~ - (~
JOB ADDRESS ,~Q` , ~ C ~~~~ ~'~f~ f~~
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2. OWNER i ~r MAILADDRESS ZIP PHONE
3. CONTRACTOR MAILADD(•IESS PHONE
~~~~ Ne.l ~~-~ I~ec~.~n ~ ~ H-lG ~~i ~ ~ ~f~d~~ LICENSENQ
Cm~i~ ~ ' 3
USE OF BUILDING
4.
5. Class of Work: NEB/ ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ ~ GL~,n ~' C ~~
7. Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
$, Change of Use From: Change of Use To:
g, Valuation of Work: $
Floodway Yes ^ No ^ Dev. Permit
10. Floodplain:
Fringe Yes^ No ^ BFE
Elev. cen.
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 _
APPLIC TION ACCEPTED BY 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 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 within 2 years of date of issue.
SIGNATURE OF OWNERJCONTRACTOR 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
Rough-in ~~ ~C~ ABC ~~)- ~~'
Final ~ /-~~ ~~~
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough-in
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS
Comment: Approved By: ,
POUNDS PRTO: Blelr, NE
Final
YOUR PERMIT
Rev. 10/91
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