BP7676L ~ , ~ ~ ~~ ~ ~~~~~ ~ ~ ~ ~ »V~I~ u L ~L= L-~ - ~i~~L~~~` ~~~ ~~~~~~
~`' ~ " ~ I Issue Date: ~ " ~ ~~ /
Application Date:
6. Total Sq. Footage (Including Basement and Garage): Total FInlShed Area:
7. Valuation of Work: $ ~-~ (~ ~`~
Floodway O Yes O No Dev. Permit
Elev
Cert
~. Floodplain: Fringe O Yes ®No BFE .
.
9. Current Zoning: O Site Plan Attached ®Complete Plans Attached
Approximate Completion Date ~ ~ r~~ y ~.
10. State Fire Marshall Required: ®Yes ®No
Inspections Required and Fees
11. Special Use Permit Required: ®Yes ®No Utilities
12. Variance Required: ®Yes ®No Sewer Water Service
13. Minimum Setbacks: Front Side Rear
Septic
Remote
14. Sidewalk Required: O Yes ®No Waiver Approved Stop Box Card
6uildin
~~'~ Footings Drywall
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septic systems. Bymysignaturebelow,lacknowledgethatpayment (before finish)
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. I understand thatthis permit is void if work is not commenced within Final Permanent Service
e of issue.
18 s or is not completed within 2 years of d
a
t Temporary Service
A~
'y
~
6 °
Mechanical
SIGNATURE OF OWNER/CONTRACTOR DATE Rough-in A\C
Final
Comment:
Plumbing
Ground Work
Rough-in
Final
WHEN PROPERLY VALID FTED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: ~ 1 ;~
POUNDS PRTG: Blair, NE ~ Rev. 8/96
" I
.~~~ ,b~~«~~AIR ~j] WASHINGTON COUNTY ^ OTHER
LOCATION OF INSP~CTIONc `~j ,~ln ~~ ___
NAME OFOWNER: -1~c~t"17`" ~ ,~ t a CONTRACTOR: 7~'~*~`t f ~z~ ~'~S/
DATEINSPECTIONREQUESTED: ,~f ~" ~i~ PERMITNO: _.~~
.,
TIME INSPECTION REQUESTED: ``~ ~/d
TYPE OF INSPECTION REQUESTED:
BUILDING: / ~~
^ FOOTING ^ FRAMING ^ DRYWALL AL
UTILITIES:
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
ELECTRICAL:
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
^ PERMANENT SERVICE ^ TEMPORARY SERVICE
MECHAMCAL:
^ ROUGH-IN ^ A/C ^ FINAL
PLUMBING:
^ GROUNDWORK ^ ROUGH-IN ^ FINAL
RESULTS OF THE INSPECTIONS PASSED ~sEExoTFS> ^ FAILED ~s~xo~s~
NOTES/REMARKS:
CALLED OPPD\
TO CONNECT SERVICE:
WANT OFFICE STAFF TO CALL OPPD\
^ YES ^ NO
^ YES ^N0 BLR1
DATE OF INSPECTION. MADE: / / ~/ TIME: ~ ~ ~~