BP7294
Permit Fee: `, .c~~C"'> Jurisdiction of City of flair, Nebraska
218 South 16th Street
issuance Fee: Slair, Nebraska 68008
®eposit Receipt #: (402) 42G-4191 ®Fak (402) 426®4195 Permit
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Application Date: ~ ° ~ ~ `~ d ~ Issue Date: ~' Z-~
LEGAL
~!i 1. DESCR. LOT Nt). BLK. TRACT
®SEE ATTACHED SHEET
0 ER ~ ~ ~ MAIL ADDRESS ~ ~ ~ZCIP~ ~ ~ PHONE ~ ~ I
2
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CONTRA R
3
~ M ADDRESS ZIP PHONE
~ g ~ 2~ m~~
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4. Class of Work: NEW ®ADDITION ®REMODEL
5. Describe Work: ®Finished Basement ®Unfinished Basement
* n ~ ~ -~ ) ~ l~ ~
~. Total Sq. FOOtage (Including Basement and Garage}: TOtal FInlShed Area:
7. Valuation of Work: $ ~ ,
Floodway O Yes O No Dev. Permit
Elev. Cert.
Flood
lain:
8
.
p
Fringe O Yes O No BFE
9. Current Zoning: ®Site Plan Attached ®_ Com lete Plans Attached
Approximate Completion Date
10. State Fire Marshall Required: ®Yes O No
Inspecti®ns Required and Fees
11. Special Use Permit Required: O Yes O No Utilities
12. Variance Required: O Yes ®No Sewer Water Service
13. Minimum Setbacks: Front Side Rear
Septic Remote
14. Sidewalk Required: O Yes ®No Waiver Approved Stop Box Card
6uildina
N®T'ICE Footings Drywall
Separate permits are required for electrical, plumbing, heating, ventilating and air (before finish)
conditioning, and septic systems. By mysignature below, I acknowledge that payment ,~ r
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 copyof this application form signed by the 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.lunderstand atthispermitisvoidifworkisnotcommencedwlthin Final Permanent Service
18 ays o is of complet ' hin 2 year of da of issue.
9
Temporary Service
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;-; ~ ~ ~'
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Mechanical
S ATURE OF OWN CONTRACTOR DATE Rough-in A\C
Final
Comment:
Plumbin
Ground Work
Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By:
~,.~.,
POUNDS PRTG: Blair, NE /~ Rev. Bl96
~~ ~;
'~CTTl' OF B~AIR ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION: ~"~.- 1~~~ ~ ~C ' ~f ~~`' 'J~~~~
~ (/~ / f/
NAME OF OWNER: F%9 ~1 vl ~c~'~ CONTRACTOR: ~`<~/''~ ~~f
,r
.DATE INSPECTION REQUESTED: ,!~~ -~P~MITNO: ~~r
TIME INSPECTION REQUESTED: `' ~' ~ ,~
TYPE OF INSPECTION REQUESTED: ~Q
BUILDING: ~`, ~~-,~_}IJ
Vt
^ FOOTING ^ FRAMING ^ DRYWALL ~_?FINAL
UTILITIES:
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
ELECTRICAL:
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
^ PERMANENT SERVICE ^ TEMPORARY SERVICE
MECHANICAL:
'~ ^ ROUGH-IN ^ A/C ^ FINAL
PLUMBING:
^ GROUNDWORK ^ ROUGH-IN ^ FINAL
RESULTS OF THEINSPECTION: SSED (s~xo~rES) ^ FAII.,ED (s~xo~s)
NOTES/REMARKS;
CALLED OPPD\ TO CONNECT SERVICE: ^ YES ^ NO
WANT OFFICE STAFF TO CALL OPPD\ ^ YES ^ NO BLR 1 i
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DATE OF INSPECTION MADE: -~ 4 /~ ~ ~ ~ TIME: ' ~ ~°' ''~