BP7374I_ ') .:
Application Date: ~ l f I ~ ~i Issue Date: ~ ` 1 t I ~~
6. Total Sq. FOOtage (Including Basement and Garage):
7. Valuation of Work: $ ~ ~~U ~°
Floodway O Yes O No
8. Floodplain: Fringe O Yes O No
9. Current Zoning:
10. State Fire Marshall Required: ®Yes
11. Special Use Permit Required: ®Yes
12. Variance Required: ®Yes O No
13. Minimum Setbacks: Front Si
14. Sidewalk Required: ®Yes ®No
O No
O No
Rear
Waiver Approved .
N®TICE
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 shalt not be
commenced until I have received a copyof 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.lunderstan Ispe t Isvoidifworkisnotcommencedwlthin
180 days gris~yot completed vithin 2 years o~date of issue
DATE
Elev. Cert
® Site Plan Attached ®Complete Plans Attached
Approximate Completion Date ~ ~ ~ ~ 1 g
Inspections Required and Fees
Utilities
Sewer_
Septic _
Buildina
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical _
Rough-in
Final
Plumbing -
Ground Work
Rough-in _
Final
I WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Dev. Permit
BFE
Total Finished Area:
Water Service
Remote
Stop Box Card
Drywall
(before finish)
Final ~ (~ ~ '~'r~ ~_~
Fixtures
Permanent Service
A\C
POUNDS PRTG: Blair, NE Rev. el96
- -----
--- __
- --- __-
~-
-. -
,t .` r
~ ^~"=CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER ~
/9 r ~~e ~ .~ ~r I
1 ~ , LOCATION OF INSPECTION: : ~ ~~' `'~
ii
NAME OF OWNER ~>? ~'~ ~:~~ ~ ~4'~-, f°< < , CONTRACTOR. ~ =- ~ c r, , t,!a ~.. ~ -~ ~
r:
DATE INSPECTION REQUESTED: PERMIT N0: ~'~:~-~' r%~~
j TIME INSPECTION REQUESTED:
~~:~~ ~ .
C TYPE OF INSPECTION REQUESTED:
BUILDING: ~ ~ ' ~
^ FOOTING ^ FRAMING ^ DRYWALL ['FINAL .,_ ~-~--~.~ r_47~T "'
f` r
i UTILITIES: ~ ` ~ '
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
REMOTE ^ WATER SERVICE
a3 ELECTRICAL:
~ I~
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
ENT SERVICE TEMPORARY SERVICE
PERMAN
~ ^ ;~~
• MECHANICAL:
~.
r
' ^ ROUGH-IN ^ A/C ^ FINAL I'
i
PLUMBING:
~.
^ GROUNDWORK ^ ROUGH-IN ^ FINAL
h_ i
RESULTS OF THEINSPECTIONSSED (saarro~rES) ^FAILED (sEarroTas>
{
NOTES/REMARKS:
~~ -
,t
- ~ DATE OF INSPECTION MADE:~c~ ~ ~ ~~*~' -- TIME: ~, f~
3
- ~ CALLED OPPD\ TO CONNECT SERVICE: ^ YES ^ NO ~
- {
~ WANT OFFICE STAFF TO CALL OPPD\' ^ YES ^ NO BLR.1 i '