BP76586. Total Sq. FOOtage (Including Basement and Garage):
7. Valuation of Work: $ ~~"> ~'
Floodway O Yes
Floodplain:
~
O O No
O
.
Fringe
Yes No
9. Current Zoning:
10. State Fire Marshall Required: ®Yes
11. Special Use Permit Required: ®Yes
12. Variance Required: ®Yes ®No
13. Minimum Setbacks: Front Si
14. Sidewalk Required: ®Yes ®No
® No
®No
Dev. Permit
BFE
Rear
Waiver Approved .
N®°fICE
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
180 days or is not completed within 2 years of date of issue.
OF
'`
DATE
Elev. Cert.
O Site Plan Attached ~~~ ~ plete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer_
Septic _
Euildin
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical _
Rough-in
Final
Plumbin _
Ground Work
Rough-in
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Total Finished Area:
Water Service
Remote
Stop Box Card
Drywall
(before finish)
Final ,`~7
Fixtures
Permanent Service
A\C
POUNDS PRTG.-Blair, NE Rev. B/96
F i I
ITI ~ G I EC'.~I® E T I
0-CITY OF BI:AIR ^ WASHINGTON COUNTY ^ OTHER
F. r I
t LOCATION OF INSPECTION: ° '' `~ ~"
~,.7=-~' ~C y,~g'".=-H=er CONTRACTOR: i~:`-~`~fe,~
NAME OF OWNER: ` `
` .fi ~'
_- g.% /I ~ rte. ~ p ~.../"'' `"' 4 II
' ' " DATE INSPECTION REQUESTED: ' ~' `~~=' r ~ PERMIT NO: ~.~'';~ ~-%
r
~., ~,~ _ ~
TIME INSPECTION REQUESTED: ~'~ i'~ ~``'
F .r }
i
E,.. 1
TYPE OF INSPECTION REQUESTED: j
~ ,~ ~~
BUILDING: ~-~"'~ ~fi' i
3 _~:,,~-
^ FOOTING ^ FRAMING ^ DRYWALL(~FINAL Ilp
~`:
UTILI--TIES: ~~
~`
I z
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
i
~' ELECTRICAL: ~ I
. G!
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
~ ^ PERMANINT SERVICE ^ TEMPORARY SERVICE ~ i
MECHANICAL:
{
4 ^ ROUGH-IN ^ A/C ^ FINAL
PLUMBING:
^ GROUNDWORK ^ ROUGH IN ^ FINAL
~. RESULTS OF THEINSPECTION: - ASSED (s~xoTES) ^ FAILED (s~xo`rFSy
F
F' NOTES/REMARKS.:
~ DATE OF INSPECTION MADE:. `°` `~ ` - TIME: s -° ~ -`z ~
~:
CALLED OPPD\ TO CONNECT SERVICE: ^ YES ^ NO
WANT OFFICE-STAFF TO CALL OPPD\ ^ YES ^:NO' BLR 1 ~
-,
!". __