BP8199The City of Blair Building Permit Detail
Permit #: 8199 Issued: 06/29/1998
Completed: 08/13/1998
Type: Siding Permits -All types
Valuation: $11,500.00
Owner: Roland Davis Jr.
Address: 13647 US Hwy. 75
Blair, NE 68008
Phone: 402-426-4833
Section: Township:
Subdivision:
Siding & replace 10 windows.
Inspections Date By
08/13/1998 KAR
Range:
Lot:
Final Inspection of Project
Permit Fee: $15.00
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Pass
Remarks
Contractors
Jorgensen Contracting, Inc.
General Contractor
Permit # Issued
~~ ~ BUIL®ING PERMIT APPLI
~ s~j Jurisdiction of City of Blair, Nebraska
Permit Fee: I.~ ~ 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008
Deposit Receipt #: - (402) 426-4191 • Fax (402) 426-4195
Application Date:.1~ 1.-Vl~., 2~, ~ ~l ~ ~ Issue Date:
CATION
Permit-
JOB ADDRESS
~~?~
~~
~.
LEGAL
1. DESCR. LOT NO. ~~ BLK. TRACT ~~ ` I
- ^ SEE ATTACHED SHEET
OWNER ` ` - 2 MAIL ADDRESS Zlp PHONE
CO TRACTOR MAILADDRESS ~ ZIP ~ HONE
4. Class of Work: O NEW O ADDITION O REMODEL
5. Describe Work: '~ '`t ~ ~ ~ ~ ~~~, S O Finished Basement O Unfinished Basement
6. Total Sq. Footage (lncl~ding Basement and Garage): Total Finished Area:
7. Valuation of Work: $ l
Floodway fJ Yes
8. Floodplain: Fringe O Yes O No
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 O No
O No
O No
13. Minimum Setbacks: Front Side Rear
14. Sidewalk Required: O Yes ~ No Waiver Approved .
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septicsystems. By mysignature below, I acknowledge thatpayment
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 by the Building
Inspector.
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
S ofNebraska.lunderstandthatthispermitisvoidifworkisnotcommencedwithin
SO ays or is not completed within 2 years of date of issue
OF
Comment:
rn_
DATE
O Site Plan Attached Cam lete Plans Attached
~ ' Z ~ _
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Water Service
Septic Remote
Stop Box Card
Buildina
Footings Drywall
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A1C
Final
Plumbtna _
Ground Work
Rough-in
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By; ~~
X199.
POUNDS PRTG: Blair, NE _ Rev. 8l9a
~ ~
F - _._ -
~~_ -BUILDING INSPECTION REPORT
. CITY OF BLAIIt ~ WASI-IING,TON C~,O?UNTY ~ OTHER
LOCATION OF INSPEC~ON: ' ~ %-~ C~~ ~~~ ~ ~rU f
NAME OF OWNER: ~j,~)' ~~~ t (~1 U V :~~pNTRACTOR: c'"J ~~~'I''~'~'~
DATE INSPECTION REQUESTED; - ) G ~'. PERMIT N0: ~~ ~
~~ l=~i "~ ~l ~
-~ /
f TIME WSPECTION REQUESTED: ~' ~ ~ 1 f'~'' . `
TYPE OF INSPECTION REQUESTED: ~ ~~~ ri
. ,,~,,.i
BUILDING: ii
L ~ ~
~.
[] FOOTING . Q FRAMING ~ DRYWALL FINAL
UTILITIES:
SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
ELIrCTR[CAL:
D:ROUGH IN ~ FIXTURES ^ FINAL ~ MOTORS
PERMANENT SERVICE :~ ^ TEMPORARY SERVICE
MECHANICAL:
ROUGH-IN Q A/C ^ FINAL
PLUMBING:
^GROUNDWORK ROUGH-IN QFINAL-
RESULTS OF THE INSPECTION: SSED (s~NOTES~ ^ FAILED (sEExoTES
.~ NOTES/REMARKS: ' i
_,. , .la`ISPECTORt
r a 1
. DATE OF INSPECTION MADE: TIME: ~; ~/~
CALLED OPPD\ TO CONNECT SERVICE: OYES ~ NO
-WANT OFFICE STAFF TO CALL OPPD\~ ~~ YES.
-- _:._._. . ~.~ ~ - ON0 BLR 1
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