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BP7448~~ BUILDING PERMIT APPLICATION Permit Fee: ~~, ~ o Issuance Fee: ~.3 a s '~ Deposit Receipt #: Application Date: ~© -" ~ ` ~ ~ Issue Date: JOB ADDRESS O ,~ LEGAL 1. DESCR. LOT NO. BLK. TRACT ^ SEE ATTACHED SHEET OWNER ~ 2. AILADDRESS . Dv~ ZIP PHONE ~-.~~~~ CONTRACT R 3. MAIL ADDRESS ZIP PHONE 4. Class of Work: O NEW O ADDITION O REMODEL 5. Describe Work: O Finished Basement O Unfinished Basement 6. Total Sq. FOOtage (Including Basement and Garage): TOtal FInlShed Area; 7. Valuation of Work: $ /5p p , C9 ~ Floodway O Yes O No 8. Floodplain: Fringe O Yes O No Dev. Permit eFE 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 13. Minimum Setbacks: Front 14. Sidewalk Required: ~ Yes O Nc 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 Side Rear 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 of Nebraska. I understand thatthis permit is void if work is not commenced within 180 days or is not complete within 2 years of date of issue. SIGNATURE 0 0 NER/CONTRACTOR DATE Comment: POUNDS PRTG.-Blair, NE O Site Plan Attached O Complete Plans Attached Approximate Completion Date , ~/ ~ - 9l0 Inspections Required and Fees Utilities Sewer Water Service Septic Remote Stop Box Card Buildin Footings Drywall '~ Framing (before finish) y Final f ~ ~~ L 7 Electrical Rough-in Fixtures Final Permanent Service Temporary Service Mechanical Rough-in A\C Final Plumbina Ground Work Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Approved By: .~ ~~ Rev. 8196 7448 DATE OF INSPECTION. MADE: ~`~~ ~ /~ ~, r~ TIME: CALLED OPPD\ TO CONNECT SERVICE: _ _, , WANT OFFICE STAFF TO CALL OPPD\ Q Y-ES -`~ N0 Y~.S ^ NO ; . BLR i