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BP7583I ll rl I~ ~ -l~ ~, ~`, I a ~ 1 11, ~ ~ r ~ ~, 1 i i I ~q ~'~ i ~' P! ~: .. ~ u ~®P p ~ ~~~ ~~l-: Jurisdiction of City of flair, Nebraska Permit Fee: 218 youth 16th street Issuance Fee: flair, Nebraska 68008 Deposit Receipt #: (402) 42G-4191 ®FaX (402) 426-4195 Permit Application Date: Issue Date:~~%~S~ri~~~ - 4. Class of Work: ®NEW ® REMODEL 5. Describe Work: ~(„ _,~ „~ ~ _ ®Finished Basement ®Unfinished Basement 6. Total Sq. Footage (Including Basement and Garage): Total FInlShed Area: 7. Valuation of Work: $ ©~, ~ r ® b Floodway O Yes O No Dev. Permit 8. Floodplain: Fringe O Yes ®No BFE Elev. Cert. 9. Current Zoning: 10. State Fire Marshall Required: ®Yes ®No 11. Special Use Permit Required: ®Yes ®No 12. Variance Required: ®Yes ®No 13. Minimum Setbacks: Front Side Rear 14. Sidewalk Required: ®Yes ®No 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 shall 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. I understand that this permit is void if work is not commenced within 180 days or is not comp ~ within 2 years ofd a of issue. ..- SIGNATURE OFOWNER/CONTRACTOR DATE Comment; ~~ /~~-~ ® Site Plan Attached ®Complete PI ns Attached Approximate Completion Date ~" d ~' Inspecti®ns Required and Fees Utilities Sewer Septic t3uildin Footings Framing Electrical Rough-in Final Temporary Service Mechanical Rough-in _ Final Plumbing Ground Work Rough-in - Water Service Remote Stop Box Card Drywall (before finish) ~- ` Cry Final ~" Fixtures Permanent Service A\C Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT app ed By: POUNDS PRTG: Blair, NE Rev. 6/96 ;_ r --~= IJI CI T g ;. , CITY OF BLAIR ~ WASHIIVGTON COUNTY ~ OTHER `° - LOCATION OF INSPECTION: ~;'~ ~ ~' ` ~` ~ ~` ~ '~::=_'~ - ` r~ - NAME OFOWNER: - '~--~'' .~'"•'~ • ~ CONTRACTOR: ~ ~ ~ ,~ j _"1 f1J DATEINSPECTIONRE UESTED: L~ ~-~-% 1`~ r,' Q ~ PERMIT N0: . 1 TIME INSPECTION REQUESTED:' %'~`` I r' -TYPE OF INSPECTION REQUESTED: BUILDING:. _ ^ FOOTING ^ FRAMING ^ DRYWALL ITI'ILITIESc ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE ELECTRICAL: ~~``- ^ ROUGH IN ^ FIXTURES ~ FINAL ~ MOTORS i ^ PERMANENT SERVICE ^ TEMPORARY SERVICE MECHANICAL: ^ ROUGH-IN ^ A/C ^ FINAL 1 111 PLUMBING: . ^ GROUNDWORK ^ ROUGH-W ^ FINAL RESULTS OF THE INSPECTION: ~pASSED ~s~xoTES> ^FAILED (s~xo~rFS~ NOTES/REMARKS: //// ---- - _ _ -=-- INSP - -- _-_ _ _ -- -- - - - --=- G '\ ~ .DATE OF INSPECTION MADE TIME: CALLED OPPD\ TO CONNECT SERVICE: ^ YES ~ NO • ~ WANT OFFICE~STAFF TO CALL OPPD\ „,. _. ^ YES ^NO BLR 1 "~