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BP7821~UILDINC~ PERMIT ~-PPLI Permit Fee: , C~C'~ Jurisdiction of City of Blair, Nebraska 218 South 16th Street Issuance Fee: ~~ Blair, Nebraska 68008 Deposit Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit 7821 Application Date: ~ ' ~ r ~ ~ Issue Date: ~] ` ~~~~ JOB ADDRESS Q ./7 ~ ~x ~p' `CI LEGAL 1. DESCR. LOT NO... I L l ~ BLK. TRACT ~ - ~ ~ ~ l / ^ SEE ATTACHED SHEET OWNER 2. ` ~ ~ - l I ~ MAILADDRESS ZIP PHONE U U vU f~ 1 ~,~ ,, {, ~, / / 3. CONTRA T~ ~ ~ ~ U ~ ~ IL A~ RES~~~,~ C/ ~ ~/u 1 1 ZI(/'~ lS/'~ l0 l ~~ PHZ :SS 4. Class of Work: NEW O ADDITION O REMODEL 5. Describe Work: ~~ f ~ ~ ~ e~ 7~/V ~ O Finished Basement O Unfinished Basement Y 1~ 6. Total Sq. Footage (IRCIudiRg Basement and Garage): Total Finished Area: 7. Valuation of Work: $ p~ ~(~Q Floodway O Yes O No Dev. Permil 8. Floodplain: Fringe O Yes O No 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 Rear 14. Sidewalk Required: O Yes O No Waiver Approved O Site Plan Attached ~ Comp to Plans Attached Approximate Completion Date / ~~` 7 Inspections Required and Fees Utilities Sewer_ Septic _ Buildina Footings 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 that this permit is void if work is not commenced within 180 days or is not completed withinr2 years of date of ' sue. Comment: OF OWNER/CONTRACTOR DATE Framing Electrical Rough-in Final Temporary Service Mechanical Rough-in _ Final Plumbin . Ground Work Rough-in _ Water Service Remote Stop Box Card Drywall (before finish) Final ~~~ Y~~ Fixtures Permanent Service A\C Final WHEN PROPERLY VALIDATE Approved By; ~r C~T1~IV THIS SPACE) THIS IS YOUR PERMIT POUNDS PRTG: Blair, NE ~ Rev. 8196 i \ I ~,, ~ 'u. N~d~ ~ ~ ~ ~~v Q ~ .y, i:~ (~J u ~~ ~, ~ \ ~\~ ~~~ ~ Nat C~ ~ ~ ~ o ~ ^ ~ F ~` ~ ~ ~ ~~ ~ !v ^~n ~.~~ ~ `~ o o~33J ~ ~ ~ .~~ o w ~ ~ ~ h7 N.~~ ~ ~ ~ ~ ~ ~ a y z ~ Vl ~ ~ ~ ~ ~ ~ ~ ~' a o. ~ Zi ~.° V o ti w O a ~ ^ ° ~~ ~ a ~ U ~ ~ w O } 7 I+'I O ~ ~ N y cc U O U U _L U _Z O O ~ ~ W A p ~. ~ ~ O x O ~ .F"] v ~ ~ a '~ tc ~ `~' W a a V a ~ U a s x a ~ ~ m ^ ~ ^ ^ w ^ ^ ~ ^ a ^ ~ ~{' o ~ U W ^ ~ ~ ~ i \a \U a , 'z r o v ° `U ~ ~~"J + H cE7 ~~ r k v ~Z-I A ~ 3 0 ^ ~ ` ~ _ ~ \ ~ ~ ~ ,; ~ ~ ~ ~ o ~ `~ M 1+1 I 1 w O ~ . U ^ -a° O O ~j z o cw. ~ ~ ` ~~~a ~ ~ o 3 ° 5 ~ ^ , ~ ^ ~ ~ ~ yp~ ~ D A y ~ [y z a ~ ~ v ^ o o ^ ~ o G ' ~ E' e _z, Z O F O y F E ~ w O ~ ~ ~ ~ ~ ~ ~ U Z ~ _ ~ ~ ~ m 0 a ~ ti ^ o ~ a_ . Q ~ ^ W ~ ^ ~ - ~ G ``~.'` ' ~ I 1, H rryrI~,, 1 1 a0 F ~ ~ ~ ~ W O ~+ f.1 ~~ ~ ~ ~ ~ .7 a < F N Ems., W J \ /~ ~ I'~ ..] E-H ^~ ~g '' ~ / a ~ s ~ ~ --~ I a ~, ~ rr~ H ~~ ~ ci ° "' ~ ~ ~ ~ ~ s' ~ p U I A I a ~~~ i ~ a ~~ ~ z OO+ [a~i ~ O ~ ~ U ^ y~ W X31 ~ ^ ^ w ~ ^ i ~'!1 yz O V~O ~O uyy"S r" ~~ yV ~- ZU' A ttW~~ ([F~! F !V~ ~ ~ U ~ U ~ - v c~ g s ~' o y ~ a ~ .°a u°. a ~ ~. ti °~ cEi °a a u a° ~ ~ ~ z ~ ^ ~ ^ o W ^ ^ ~ ^ 4 ^ ~ o o ~ z a ~ ~ ~ . o o h U O ^ ~ °z ~. I 1 0 O a 0 ¢i m i, °z z°I ^ ^! z z~ . ^ ^1 ^ ^; U 0 o i -, w F i d U o ~ ~ O i ~.l 3 ~.~ mI °z °z~ ^ ^ -! i~ ~. ^ ^ ~ w 5 ~ ~ ..: ~ '' o o' S ~ a o: U ' ~ 4 .~ ~rOr - r"y 1i y/ G y { R S a U m o lI O w O '! ~ ~. ~ a ~ 3