BP7523Permit Fee:
Issuance Fee:-
Deposit Receipt #:
218 South 16th Street
Blair, Nebraska 68008 7 5 2 3
(402) 426-4191 ~ Fax (402) 426-4195 Permit
Application Date: 1/ ~Lt l ~ ~ Issue Date: ~/2i ~ c --l
JOB ADDRESS
129
~
LEGAL
1. DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
OWNER
2. MAIL ADDRESS ZIP PHONE
CONTR TOR ,.
3. MAIL ADDRESS
I-"l.a ~ ZIP PHONE
~ a $ lbZ .3 z- ~ Sad
4. Class of Work: O NEW O ADDITION O REMODEL
5. Describe Work: ~ O Finished Basement O Unfinished Basement
6. Total Sq. Footage (IRCIudIRg easement and Garage): Total Finished Area:
7. Valuation of Work: $
~~
~
Floodway O Yes
8. FIOOdplain: 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 O No 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 acopy of this application form signed bythe 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~•rtot g~j leted witf~y,~ars of date of issue.
Comment:
OF
DATE
O Site Plan Attached O Complete Plans Attached
Approximate Completion Date 2 j Z-l ~ ~i `l
Inspections Required and Fees
Utilities
Sewer Water Service
Septic Remote
Stop Box Card
Buildin
Footings Drywall
(before finish)
Framing Final ~ ~ Z ~~
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in _
Final
Plumbin _
Grountl Work
Rough-in _
Final
WHEN PROPERLY VALIDATED (IN THIS
Approved By~~/~
POUNDS PRTG: Blair, NE
BUILDING PERMIT APPLICATION
oO Jurisdiction of City of Blair, Nebraska
~ -,
A\C
THIS IS YOUR PERMIT
Rev. 9/96
~=~TILDING INSPECTION REP®RT
,,CITY OF BLAIR ~ WASHINGTONN COUNTY ~ OTHER
. LOCATION OF INSPECTION: ~~7~-~C_ -.~3 , .S~f
- ~ ~ 1 _ ,
NAME OF OWNER: ~~~ .G'. ~ ~ CONTRACTOR:: '~.~
DATE INSPECTION REQUESTED: :,1~- -~~'~ ~pERMIT N0: "~~
TIME INSPECTION REQUESTED:. ~'~'" '~`/ ~z ti°
TYPE OF INSPECTION REQUESTED:
BUILDING:
~ ~~3 ~^
FOOTING ^ FRAMING O DRYWALL ,FINAL
;.UTILITIES:
^ SEWIIt TAP ~ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
ELECTRICAL:
ROUGH IN ^ FIX'T'URES `0 FINAL ~ MOTORS
[] PERMANENT.:_SERVICE Q TEMPORARY SERVICE
MECHANICAL:
^ ROUGH-W ^ A/C ^ FINAL
PLUMBING: -
. ~ GRQUNDWORK ^ ROUGH-IN ~ FINAL.
RESULTS OF THE INSPECTION: PASSED ~sEE xo~s> ~ FAILED ~sEE rro~rFS~ '
' ~ . NOTES/REMARKS:
~,
INSPECTOR: ~~ ~ f i,~ ~
• DATE OF INSPECTION MADE: ~ r~` ~ d TIME: ~.,~~ • ~'-.
CALLED OPPD\ TO CONNECT SERVICE: ^ YES ^ NO
~. WANT OFFICE STAFF TO CALL OPPD\ ~ YES ^ NO' BLR Y,
_, ..