BP7886
5. Describe Work: ~ ~ ~ ~ ~, ,,,~ ,~ ~~ ®Finished Basement O Unfinished Basement
6. Total Sq. F00tage (Including Basement and Garage): ~ Total FInlShed Area:
7. Valuation of Work: $ ~~y~
Floodway O Yes O No Dev. Permit
8. Floodplain: Fringe O Yes O No BFE Elev. Cert.
9. Current Zoning:
10. State Fire Marshall Required: ®Yes
11, Special Use Permit Required: D Yes
12. Variance Required: ®Yes O No
1~. MinimumSetbacks: Front
14. Sidewalk Required: O Yes ® N
O No
®No
Side Rear
o Waiver Approved .
N®71CE
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 understandthatthis permit is void if work is not commenced within
1130 days or is not complewithin 2 y,~ars of dye gf;i~sue.
OF OWNER/CONTRACTOR
DATE
Comment:
® Site Plan Attached Co ete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer
Septic
Buildina
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical
Rough-in
I Final
Plumbing _
Ground Work
Rough-in
Final
WHEN RE VA~Ct ATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By;
~~ w~~~
Water Service
Remote
Stop Box Card
Drywall
(before finish)
Final ~ ~ ~/ ~ ~-
Fixtures
Permanent Service
A\C
Rev. 6/96
POUNDS PRTG: Blair, NE
e- -
_ ~~~_~
~crr'7 OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
~,,.~
LOCATION OF INSPECTION: ~J~F~ ~ ~ U ~.f ~~
NAME OF OWNER: t ~'~ 1 C_, M~1 C_A,~ CONTRACTOR: ~~ ~ ~`-°+° l ~~
i
DATE INSPECTION REQUESTED: u j ~ - ~ ~ PERMIT N0: ~ -~ ~~
TIME INSPECTION REQUESTED: ~ ~ ~ ~je ~
TYPE OF INSPECTION REQUESTED:
BUILDING:
^ FOOTING ^ FRAMING ^ DRYWALL [~°FINAL
f
UTILITIES: ,.
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
^ REMOTE ^ WATER SERVICE
ELECTRICAL:
^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS
^ PERMANINT SERVICE ^ TEMPORARY SERVICE
MECHANICAL:
^ ROUGH-IN ^ A/C ^ FINAL
PLUMBING:
^ GROUNDWORK ^ ROUGH-IN ^ FINAL
RESULTS OF THE INSPECTION: ASSED ~sEa rro~s~ ^ FAILED ~s~ xo~rES~
NOTES/REMARKS:
CALLED OPPD\
TO CONNECT SERVICE:
^ YES ^ NO
^ YES ^ NO
BLR 1
WANT OFFICE STAFF TO CALL OPPD\
~(~ C~ 7
DATE OF INSPECTION MADE: ~ `.~tl `/~/ 'IgME; ~~ "ICJ