BP7319
Application Date: ~~' m_
Issue Date: ~ ~ (~' ~~~
6. Total Sq. Footage (IRCIuaiBg easement and Garage): Total Finished Area:
7. Valuation of Work: $ ~ ~1(~~"~ . ~~
Floodway O Yes O No Dev. Permit
~. Floodplain: Fringe O Yes O No BFE Elev. Cert.
9. Current Zoning:
10. State Fire Marshall Required: ®Yes
11. Special Use Permit Required: ®Yes
92. Variance Required: ®Yes O No
O No
O No
13. Minimum Setbacks: Front Side Rear
14. Sidewalk Required: O Yes ®No Waiver Approved .
N®TIC
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 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 that this permit is void if work is not commenced within
190 days or is not complet within 2 ye of date of issue.
C! ~ - F "~=
S GNATURE OF OWNEFJCCNTRACTCR DATE
Comment:
® Site Plan Attached _® Complete Plans Attached
Approximate Completion Date ~ r-~ ` ~~~
Inspecti®ns Required and Fees
Utilities
Sewer _
Septic _
Buildin
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical _
Rough-in
Final
Plumbing _
Ground Work
Rough-in
A\C
Final
WHEN PROPERLY V,
Approved By:
~~
Water Service
Remote
Stop Box Card
Drywall -
(beforefinish)
Final
Fixtures
Permanent Service
DATED (IN THIS
~~~
THIS IS YOUR PERMIT
POUNDS PRTG: Blair, NE ~ Rev. B/96
IJIJ I I I - t
,/ ~
~~ CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER I
LOCATION OF INSPECTION: ~ ~ ~ ~ ~~ ' ~ ~~ -~~G !,
NAME OF OWNER: t~ ~ ~ ~ CONTRACTOR: ~ ~'~~~ ~ i~
DATE INSPECTION RE UESTED: ` `~ PERMIT NO:
f ~f ~i tvz ~~.'f'~ `~ ~~
TIME INSPECTION REQUESTED: ~ '~,
1
TYPE OF INSPECTION REQUESTED: 1
~''~ 1
BUILDING: ~,, --°~°°~-"' 1
^ FooT~rG _ ^ FRAMIrrG ^ DRYWALL ~D~FIlVAL ~ a
~ UTILITIES:
^ SEWER TAP ^ SEWER ^ SEPTIC- ^ WATER TAP ~
^ REMOTE ^ WATER SERVICE
ELECTRICAL: ` ,j
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
~ ^ PERMANENT SERVICE ^ TEMPORARY SERVICE
~ I~~
i
~1V~ECHANICAL:
r
j ^ Roucx-Irr ^ Arc ^ FINAL ~ ' I
PLUMBING:
~'
^ GROUNDWORK ^ ROUGH IN ^ FINAL
~ RESULTS OF THE INSPECTION: SSED ~s~rroTES~ ^ FAILED (sESNOxES~ -
~ /
NOTESiREMARKS: _ ~
I
~'
'INSPE ~. ~ / I I
DATE OF INSPECTION MAD ~ r C •~E• t/~~ ~ ~ _ I
_ I
`CALLED OFPD\ TO CONNECT SERVICE; ^ YES ^ NO
t' WANT OFFICESTAFF TO CALL OPPD\ ~ - - {]-YES - ^ Nb BLR 1