BP7481BUILDING PERMIT APPLICATION
y0 OCR _ Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: { ~a~~0 Blair, Nebraska 68008 7 4 81
Deposit Receipt #: (402) 426-4191 ~ Fax (402) 426-4195 Permit
Application Date: ~ `" ~~"~ ~ Issue Date: ~l~/y~
JOB ADDRESS n ~ ~ ~X
LEGAL
1. DESCR. LOT NO. BLK. TRACT
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CHED SHEET
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2.OWNER f~, ~ C ~ Q ~ ~ ~SSAIre~DRESS ~ ~ Z
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CONTRACTOR MA
3. ~~• ~CJI ZIP PHONE
4. Class of Work: NEW O ADDITION O REMODEL
5. Describe Work: ~~CY1 .- ~~ ~ - ~ ~~ {~ O Finished Basement O Unfinished Basement
~3 ~~ - a~ SI ct_b - l 4L l,~
6. Total Sq. Footage (Including Basement ana Garage): Total Finished Area:
7. Valuation of Work: $ 4 7 (jt~ . ~
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 O No
11. Special Use Permit Required O Yes O No
12. Variance Required: O Yes O No
13. Minimum Setbacks: Front ~_ Side ~ Ream
14. Sidewalk Required: PfYes O No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, healing, ventilating and air
conditioning, and septic systems. By my signature below, l acknowledge that payment
of the building permit application fee does not constitute issuance of this building
permit. I furtheragree that construction covered by this permit application shall not be
commenced until I have received a copyof 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 Ciry of Blair and the
State ofNebr ka.lunderstandthatthispermitisvoidifworkisnotcommencedwithin
180 day~or ~ not completed within 2 years of date of issue.
OF
Comment: /~.E.~i ~~~
~"
DATE
O Site Plan Attached ~ ~,/Q~C ~e~Plans Attached
Approximate Completion Date ~ 3
Utilities
Sewer
Septic
Water Service
Remote
Stop Box Card
Buildin
Footings
Framing
Electrical
Inspections Required and Fees
Rough-in
Final
Temporary Service
Mechanical
Rough-in _
Final
Plumbin _
Ground Work
Rough-in
Drywall
(before finish) ~'~~~
r
Final
Fixtures
Permanent Service
A\C
Final
WHEN PROPERLY VALIDATED (IN THIS
YOUR PERMIT
POUNDS PRTG: Blair, NE Rev. 8/96
• • ~ ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 0 4 2 4
(402) 426-4191 Permit
~ ~a
Application Date: ~ " Permit Fee: $
JOB ADDRESS J /
`/
LEGAL
1 • DESCR. LOT NO. BLK. TRACT
O SEE ATTACHED SHEET
2 OWNER MAILADDRESS ZIP PHONE
3 CTOR MAIL AD RESS
NE
r ENSE NO
~ ~
4• Cla f Work: O NEW RESIDENTIAL O NEW COMMERCIAL REMODELING/ADDITIONS O UPGRADE SERVICE
5• Describe Work:
6• Current License on File O Yes O No O NA
ELECTRICAL PERMIT FEES
New Service Fee = (Amp Fee + $2.00 per branch circuit)
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00
101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00
201.300 Amp Fee ............................ $ 30.00
Fire Alarm System ................. $10.00
301.400 Am Fee $ 42.00
p ............................
401-500 Amp Fee ............................ $ 55.00 Signs ..................................... $15.00
501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11.00
601-700 Amp Fee ............................ $ 80.00
701-800 Amp Fee ............................ $ 92,00
801-900 Amp Fee ............................ $105.00 Commercial/MUlti-Family and All Upgrades:
901-1000 Amp ................................. $117.00 # of Circuits x $2,00 ~-
IFOVER 1000 Amp
1st 1000 Amp Fee ....................... $117.00 Amp Fee ~ ~
Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total
NOTICE New Residential: (Finished Area)
I hereby certify that I have read and examined this Single/Two Family Dwellings
application and know the same to be true and correct. All sq. ft. x .045
provisions of laws and ordinances governing this type of
k
ill b
li
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d
h
h
f
wor
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e comp
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er speci
ied herein or not.
The granting of a permit does not presume to give authority
to violate or cancel the
rovisions of an
other state or local Receptacle/Switch Outlets / ~' O
p
y Fixtures ~- x $.75
law regulating construction or the performance of
construction.
Residential/Commercial Appliance
# Fixect Outlets x $3.00
` Power Apparatus (220 Volts)
# A
aratus x $3
00
pp
.
S URE OF RACTOR OR AUTHORIZED AGENT
Z -- ~
Permit Issuance Fee $15.00 d C~
f
DATE
TOTAL
~ `-
WHEN PROPERLY VALIDATED (IN THIS SPAN-kIJ~S YOUR PERMIT
Comment:
Approved By;
POUNDS PRTG: Blair, NE Rev. 12/95
CITY OF BLAIR
Application for Building Permit
PLOT PLAN
Address ~~ ~ ~ ~G' /'I Date
Legal Description: Lot Block Addition ~ s-~° ~ ~~~_
~l/,~
Please show all measurements of existing and contemplated structures,
also show distances between s~,t~ructures, etc., and property lines.
Is this a corner lot? (N®
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Indicate North
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