P19970916Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~~-/l
PLUMBING PERMIT FEES
Comments:
Type of Fixture
N®TIC
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local
law regulating construction or the performance of
construction.
~~,,0 'SIGNATURE OF CONTRACTO~*R OR AUTHORIZED AGENT
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DATE
Kitchen .................................. $8.00 x
Bath ....................................... $8.00 x
Rough-In Bath ....................... $4.00 x
Utility ..................................... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Water Service ........................ $10.00
Sewer .................................... $10.00
Groundwork ........................... $10.00
Septic Tank & Laterals .......... $10.00
Lawn Sprinkler System..........$10.00
Sprinkler System ................... $30.00
(Commercial)
Permit Issuance Fee ............. $15.00
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Permit Fee: $ t ~~-~~'~°`
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T®TAL ~`~ ~ ~~
Current License on File 17Yes ®No ®NA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approv d - R
POUNDS PRTG: Blair, NE Rev. 12/95
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- ~ ~ ~ CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
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LOCATION OF INSPECTION:
NAME OF OWNER: _ ~ ~~ ~ ~'"v`im`- CONTRACTOR: f`~`~-'` ' ~`~`~~
DATE INSPECTION REQUE}pS'hT`ED~G7:(~~ ~ ~ f °-" ~' ~ PERMIT N0:
TIME INSPECTION REQUESTED: ~ ~ ~ ' ~~ ' ~. s` ~ . { 3_~ 'j
TYPE OF INSPECTION REQUESTED:
- ~~
BUILDING: ~-
^ FOOTING ^ FRAMIlVG ^ DRYWALL ^ FINAL
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UTILITIES: ~ ~
~(~
1
^ SEWER TAP r3EWER ^ SEPTIC ^ WATER TAP ~
~, ~ i'
^ REMOTE WATER SERVICE
ELECTRICAL: v
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
^ PERMANINT SERVICE ^ TEMPORARY SERVICE
a
MECHANICAL:
^ ROUGH-IN ^ A/C [] FINAL j
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PLUMBING:
^ GROUNDWORK ^ ROUGH-IN ^ FINAL
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RESULTS OF THE INSPECTION: .PASSED ~s~NOi~s) ^ FAILED ~s~rro~ras~
-----.-._-__! I~IO_TFS(REMARKS~ _. _. _-----
INSPECTOR: -
- l1 r
' DATE OF INSPECTION MADE: TIME:
CALLED OPPD\ TO CONNECT SERVICE:
. ^ YES ^ NO
1
. WANT OFFICE STAFF TO CALL OPPD\ ^ .YES ^ NO BLR 1