BP7307' BUILDING PERMIT APPLI
e~ Jurisdiction of City of Blair, Nebraska
Permit Fee: ~ 5 -~ ~- P~. 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008
Deposit Receipt #: (402) 426-4191 • Fax (402) 426-4195
Permit
7307
Application Date: ~ J ~U ` Q ~ Issue Date: ~ Z,~9~
JOB ADDRESS ~ ~ I
+ 1
I
LEGAL
1 . DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2.OWNER MAILA ~ RE, 3~5, , ~ ~ ~~
1 ~ ZIP ~ ~~ _ `~ HONE
CONTRACTOR MAIL ADDRESS
h ~ ~~~~~IP ~ ~ ~ ( ~~ PHONEJ _'
4. Class of Work: O NEW O ADDITION O REMODEL
5. Describe Work: ._ -~r d~' ~ l °er ~ Finished Basement O Unfinished Basement
~ ~~
6. Total Sq. FOOtage (Including Basement and Garage): Total FInlShed Area:
a
7. Valuation of Work: $~ ~jj(po~
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 O No
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, healing, 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 of Nebraska. I understand that this permit is void if work is not commenced within
180 day or is not completed wit 'n 2 years of date of issue.
~/~ ~~
SIGNATU OF OWNER/CONTRACTOR DATE
Comment:
O Site Plan Attached O Complete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Water Service
Septic Remote
Stop Box Card
Buildin
Footings Drywall
(before finish)
Framin Final ~" Z U" Y 7
g
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A1C
Final
Plumbing -
Ground Work
Rough-in _
Final
WHEN PROPERLY VALID TED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: ~/
CATI®N
POUNDS PRTG: Blair, NE V Rev. 6196
--- - -
BUILDING INSPECTION REPORT
E ~ CTTY''OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
Fr .. ~ -
LOCATION OF INSPECTION: ~~ a ~}~'~''?`•
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` NAME'OF OWNER ~ c, yap ~~~~ ~;f€~-~t CONTRACTOR: ~~~~~~~~~ ~~ ~+~=G;,
~ ~ , ~ ~~
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~ ,DATE INSPECTIONREQUESTED: ,~--a~~ ` .~pERMITNO: ~`~
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' ~ TIMEINSPECTIONREQUESTED: ~~ f~l~tr°
TYPE OF INSPECTIONREQUESTED: ~
e BUILDING: ~~
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^ FOOTING ^ FRAMING ^ DRYWALL ~"FIIVAL
UTILITIES; .
k ^ SEWER TAP ^ SEWER
~, ^ SEPTIC ^ WATER TAP
,^ REMOTE ^ WATER SERVICE ~
f ELECTRICAL: _
f
^.ROUGH IN ^ FDfTURES ^ FINAL ^ MOTORS
. ^ PERMANENT SERVICE ^ TEMPORARY SERVICE
'_ ~ .MECHANICAL:
~:, = ^ ROUGH-IN ^ A/C ^ FWAL
PLUMBING: ~
E ',
~~ ^ GROUNDWORK ^ ROUGH W ^ FINAL ~I
~ 1
~ RESULTS OF THEINSPECTION:PASSED ~sEErro~rES~ ^FAILED ~s~rro~s>
f~ ~`
~ NOTES/REMARKS:
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