BP7265,,~~ ~~
~i
Permit Fee: ~~ ~ ~ ~
Issuance Fee:
Deposit Receipt #:
Application
Issue Date:
7265
JOB,ADDRESS
LEGAL
1. DESCR. LOT ND. BLK. TRACT
^ SEE ATTACHED SHEET
OW~IF~R
2. MAIL ADDRESS ZIP L PHON
C RA T R
3. ~~ i n v~ ~` ~ MA ADDRESS
~ ~ ZIP
~ PHONE
~ 2 ~ -Z ~
4. Class of Work: O NEW O ADDITION O REMODEL
5. Describe Work: O Finished Basement O Unfinished Basement
` ~
n - - C~ ~ ~'
6. Total Sq. Footage (IROIudiBg Basement and Garage): Total Finished Area:
7. Valuation of Work: $ 55Q, ~ U
Floodway O Yes O No
8. FlOOdplain: Fringe O Yes O No Dev. Permit
BFE
Elev. Cert.
9. Current Zoning:
10. State Fire Marshall Required: O Yes
11. Special Use Permit Required: O Yes
12. Variance Required: O Yes l7 No
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 ~ Fax (402) 426-4195 Permit
O No
O No
13. Minimum Setbacks: Front Side Rear
14. Sidewalk Required: O Yes O No Waiver Approved .
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, 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 by the Building
Inspector.
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 ebraska.lunderstar~thatthispermitisvol~Ifworkisnotcommencedwithin
18 ays ~ not compJe~gf within 2 years of datq-of issue.
Comment:
BUILDING PERMIT APPLICATION
OF
DATE
O Site Plan Attached O Com to Plans Attached
Approximate Completion Date ~ '" l 5 "mil
Inspections Required and Fees
Utilities
Sewer
Septic
Building
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical
'~ Rough•in
Final
Plumbing .
Ground Work
Rough-in
A\C
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approvec~,B~r: - ~
Water Service
Remote
Stop Box Card
Drywall
(before finish)
Final 3' ~ ~ ~7
Fixtures
Permanent Service
POUNDS PRTG.-Blair, NE Rev. 6/96
BUILDING INSPECTION REPORT
e~.'~
CITY OF BLAIIt ^ WASHINGTON COUNTY ^ OTHER
1
LOCATION OF INSPECTION: ~ ~ ~f~~,~~ -~ ~~ ~ ~
NAME OF OWNER:~~~ CONTIRACTOR: /
. ~•,
DATE INSPECTION REQUESTED: «~ ` ~ ~ ° ~ ~ PERMIT NO: ~L~~~ ~ /,
TIME INSPECTION REQUESTED: ~~~~
TYPE OF INSPECTION REQUESTED: s
- BUILDING: ' ; ,/~,~
FOOTING ^ FRAMING ^ DRYWALL FINAL ,
UTILITIES: ddd
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
ELECTRICAL:
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
^ PERMANENT SERVICE ^ TEMPORARY SERVICE
MECHANICAL:
ROUGH-W ^ A/C ^ FINAL .
PLUMBING: •
^ GROUNDWORK ^ ROUGH-IN ^ FINAL .
RESULTS OF THEINSPECTION: • ~SSED (s~xo~s> ^ FAILED (s~xorES)
NOTES/REMARKS:
7TJCDC ~ ~ -. - . -