BP7218BUILDING PERMIT~4PPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 88008 j ~ -~-
(402) 426-4191 Permit
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Application Date: ~ - ~ ~~ ~ Issue Date:
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Permit Fee: $ J, f1 ~
JOB ADDRESS ~/ ~ ~ ~ ~ ~
LEGAL
1 ' DESCR. LOT NO. BL . TRACT ~~
^ SEE ATTACHED SHEET
2. OWNER ~ / - ¢~ ~ L2~ MAILADDRESS,~ ~ J ZIP "r Z~-~lo ~~ PHONE
/ ~
3. CONTRACTOR MAIL`ADDRESS
~c~ ~~.~~~ PHONE LICENSE NO.
~a a a- ~ ~~ ~ ~ 7 3
4. USE OF BUILDING ~
5. Class of Work: EW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ ~v ~~ d~- /,-2~~ .
7. Sq. Footage of Structure pnauaing BBSemeRt ana GBrege): ~ ~ ~ ~ ~
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10. Flood lain: Floodway Yes ^ No [~ Dev. Permit
p Fringe Yes^ No ~ BFE Elev. Cert.
11. Current Zoning: ~ ~~ Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date
12. State Fire Marshall Required: Yes ^ No^
Inspections Required and Fees
13. Special Use Permit Required: Yes ^ No ~ utilities
No~
14
Variance Re
uired: Yes Sewer Tap Water Tap
.
q
^ Sewer Water Service
15. Minimum Setbacks: Front Side N~~ Rear septic Remote
16. Sidewalk Required: Yes ^ No ^ Waiver Approved ~ Building
APPLICATION ACCEPTED 8Y PLANS CHECKED BY APPROVEC FOR ISSUANCE BY Footings Drywall
~j~ (beforefinish)~~i~ ~
~
l1
NOTICE Framing Final
Separate permits are required for electrical, plumbing, heating, ventilating and air condi- ,
tinning, and septic systems. By my signature below, I acknowledge that payment of the ~~ ~f
Electrical ~
~/
building permitapplicationfee does notconstitute issuance of this building permit. I further p~S=
agree that construction covered by this permit application shall not be commenced until I
have receivedacopyofthisapplicationformsignedbytheBuildinglnspectorandstamped Rough-in Permanent Service
'APPROVED'.
Iherebyagreeioperformtheproposedworkinaccordancewiththespecificationssetforth Final Tem ora Service
p ry
above and in accordance with the codes/ordinances of the City of Blair and the State of
Neb s .understand that this permit is v If work is not commenced within 180 days,
~
is t com eted within 2 ye s of the f
ssuance, or if work is abandoned for six (fi) Mechanical
m the or n i v is ear'
~-~ `9 ~
Rough-in
ABC
SIGNAT OF NE CONTRACTOR OR AUTHO IZED AGENT DATE Final
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) Ty~S~~q ~~~llir f1
Comment: Approved By:
POUNDS PRTO: Blelt, NE Rev.OSl85
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 Q 3 ~, $
(402) 426-4191 Permit
Application Date: hermit Fee: S
JOB ADDRESS ~ /'~ ~ ~Y~-./ Cf~ ~rJ
i
LEGAL
1 • DescR. LOT N0. BLK. TRACT
O SEE ATTACHED SHEET
2. OW R MAIL RESS ZIP PHONE
TOR AIL ADDRESS PHONE
3. LICENSE No.
4. Class of Work: O NEW RESIDENTIAL- O-NEW COMMERCIAL O 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 Tem ora Service $10.00
p ry ................
201-300 Amp Fee ............................ $ 30.00
Fire Alarm System ................. $10.00
301-400 Amp Fee ............................ $ 42.00
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
IF OVER 1000 Amp Amp Fee
1st 1000 Amp Fee ....................... $117.00
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
work will be complied with whether specified herein or not.
The granting of a permit does not presume to give authority Receptacle/Switch Outlets
to violate or cancel the provisions of any other state or local 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
.
SIGNATURE OF CONTRALTO R A HORIZED AGENT
G
~~
// Permit Issuance Fee $15.00 ~
~
DATE
TOTAL
j
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS-I~ YOUR PERMIT
Comment:
Approved By;
Rev. 12195
POUNDS PRTG: Blair, NE
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4 i ~f3t sae. rye ny 'i~~~ c,~fi ~?'jg~f"~'"~ ~i
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426-56751
~e Sky's the Limit"
TRAVEL & LIMOUSINE SERVICE
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ADDRE:
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TELEPHONE .~- DI
A.Q,BDX 22 .GATE:
-002-02&2873: 644fR0WtSTpEET DESIGN
FAk ADZ-0268&44 DWR;NE 6H0QB
nrurii i.gryu TR141lEL
9LAIR, NE
00011
:001
01^24.96
9Y; DON OENTON
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