BP73327
Application Date: ~~ ~ ~'~ ~~ Issue Date:
6. Total Sq. Footage (Including Basement and Garage): Total FII11Shed Area:
7. Valuation of Work: $ ~ ~ Q ~ t ~~ ~
Floodway O Yes O No Dev. Permit
Elev
Cert
FIOOdplain:
~
O
O .
.
.
No BFE
Fringe
Yes
9. Current Zoning: ®Site Plan Attached ®Complete Pla s Attached
~~ ° ~'" ~~
Approximate Completion Date
10. State Fire Marshall Required: ®Yes O No
Inspecti®ns Required and Fees
11. Special Use Permit Required: ®Yes ®No Utilities
12. Variance Required: O Yes ®No Sewer Water Service
13. Minimum Setbacks: Front Side Rear
Septic
Remote
14. Sidewalk Required: ®Yes ®No Waiver Approved Stop Box Card
Building
NOTICE Footings Drywall
Separate permits are required for electrical, plumbing, heating, ventilating and air (before finish)
conditioning, andsepticsystems.Bymysignaturebelow,lacknowledgethatpayment Q ~
~ `'
of the building permit application fee does not constitute issuance of this building
Framing ~
Final
~
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 Electrical
Inspector.
I hereby agree to perform the proposed work in accordance with the specifications set Rough-in Fixtures
forth above and in accordance with the codes/ordinances of the City of Blair and the
State of Nebraska.lunderstandthatthispermitisvoidifworkisnotcommencedwithin Final Permanent Service
180 days or is of completed within 2 years of date of issue. Temporary Service
4./ ~ ~ ~ry._ ~ ~
Mechanical
SIGNATURE OF OWNER/CONTRACTOR DATE Rough-in A\C
Final
Comment:
Plumbing -
Ground Work
Rough-in _
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By;
POUNDS PRTG.-Blair, NE Rev. 6/96
---- - -
- - ~ ~,
- , .,.:. IJ I CSI E
~~CITY OF BLAIR ^ WASHINGTON COUNTY OTHER
LOCATION OF INSPECTIOI~I:. ~ ~ f ~~ ~ r'~
i ,~ -~ ,~~
NAME OF OWNER: ~.~ '~` -~ 1 CONTRACTOR: ~ it's i ~~
- ~ `` >
DATE INSPECTION REQUESTED: ~ ~ t~' % '`(~ ~~? pERMIT N0: ~ ~.~-` ~~
TIME INSPECTION REQUESTED: t~t`~i i ~`-~ ~,;~ :`
i
TYPE OF INSPECTION REQUESTED: ~.. ~
BUILDING: ~~'
' ~ ~' ~
^ FOOTING ^ FRAMING ^ DRYWALL tAL
0 ~
UTILITIES: ~
^ SEWER ^ SEPTIC
^ SEWER TAP ^ WATER TAP
i
^ REMOTE ^ WATER SERVICE
1 ''~
ELECTRICAL:
^ ROUGH IN F f
^ IXTURES ^ FINAL ^ MOTORS l
^ PERMANENT SERVICE ^ TEMPORARY SERVICE ~
. i
' MECHAMCAL:
^ ROUGH-W ^ A/C ^ FINAL
PLUMBING: '
^ GROUNDWORK ^ ROUGH W ^ FINAL {
i
RESULTS OF THE INSPECTION: ,~pASSED (s~xoTES~ ^FAILED cs~rroTES~ ~ i
NOTES/REMARKS:
1
-_- _____
_ _. - -
-- _
' INSPECT
.DATE OF INSPECTION MADE: ~~ ~~ ~ TIME: ~~~ ~~
. CALLED OPPD\ TO CONNECT SERVICE: ^ YES ^ NO
~,
,; I
WANT OFFICE STAFF TO CALL OPPD\ ^ YES ^ NO BLR t '
• _ - -
y ~ a
a