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BP5787~~ ~(1 ~` 03<o9'z /Z- 3-9Y,~ Zoo. oo BUILDING PERMITAPPLICATIO #~z7~ ".` Jurisdiction of City of Blair, Nebraska 218 South 16th Street rn Blair, Nebraska 68008 ~(/ (402) 426-4191 Perm _ C,, ~ / Application Date: ~ ~ ~~" ~~ ~~ Issue Date: '~ I ~ ~ P t ee: $ 7~ t JOB ADDRESS n ~ i 8~,\' L,/~~ \1 rc C~ ,n J ` -) /'`~ /_ LEGAL 1, DESCR. LOT NO. BLK . TRACT ACHE OWNER ~ / MAILADDRESS ZIP O 3, CONTRACTOR G'~ C"l. ~ MAILA DRESS PHONE ,~2,~ - ~~~~~~ LICENSE NO. - ~F ~ S USE OF BUILDING 4. 5, Class of Work: NEW ADDITION r ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~ I ~j r/ ' ], Sq. FOOtage Of StrUCtUre (Including Basement and Garage): 1~~~ /~ ~~ ~~ ~ 1 ~ ~? ~° ~ C~ / 8, Change of Use From: Change of Use To: g, Valuation of Work: $ ~ ~ ~ ~ ~ ~~ 10. Floodplain: FI°°awey Yes ^ Fringe Yes^ No ^ No ^ Dev. Permit Elev. Cert. BFE 11. Current Zoning: ~ -'''1 12. State Fire Marshall Required: Yes ^ No~ 13. Special Use Permit Required: Yes ^ No [~ 14. Variance Required: Yes ^ No [~ 15. Minimum Setbacks: Front Side Rear 16. Sidewalk Required: Yes ^ No ©~Naiver Approved _ BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY NOTICE Separate permits are required for electrical, plumbing, heating, ventilating and air condi- tioning, and septic systems. By my signature below, I achnowledge 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 and stamped 'APPROVED'. 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 nd rstand that th's~ ermit j void if work is not com ®n d within 180 days or is not co plp~ed within 2 y ar ofd to f issue. - ,; ~~ ~ , , / ,/ GNAT E FO NE j ONTRACTOR OR UTH RI DRAG tJT ~ DATE SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Site Plan Attached ^ Complete Plans Attached ^ Approximate Completion Date Inspections Required and Fees Utilities Sewer Tap Water Tap Sewer Water Service Septic Remote Building Footings Drywall ~ s (before finish) ~ Framing ~ ~ Z ~ ~ f ~ ~ Final ss ~ ~" ~ ~ Electrical Rough-in °~ ~ti Fixtures Final r~ Permanent Service Temporary Service Mechanical Rough-in ./ ABC Final Plumbing Ground Work ~i Comment: Approve OUNDS PRTG: BIeIr, NE Rev. 10)5 ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 0 2 71 (402) 426-4191 Permit Application Date: 7' ~r(~~ ~# ~ 70 ~' Permit Fee: $ ~~ JOB ADDRESS ~ ~ ~ ~ v ~~~ LEGAL 1 • DescR. LOT NO. BLK. TRACT O SEE ATTACHED SHEET 2 OWNER ` „ I ~ ^ ' , ~ . MAIL ADDRESS v V v\ 1 ZIP PHONE ,3• CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.. 4. Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL REMODELING/ADDITIONS O UPGRADE SERVICE 5. Describe Work: ~ - ~~ R~,.~4 ~I 6• Current License on File O Yes O No O NA ELECTRICAL PERMIT FEES New Service Fee = (Amp Fee + $2.00 per branch circuit) 1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00 101-200 Amp Fee ............................ $ 18.00 Tem ora Service $10.00 p ry ................ 201-300 Amp Fee ............................ $ 30.00 Fire Alarm S stem $10.00 y """"""""' 301-400 Am Fee $ 42.00 p ............................ 401-500 Amp Fee ............................ $ 55.00 Signs ..................................... $15.00 501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11 00 601-700 Amp Fee ............................ $ 80.00 701-800 Amp Fee ............................ $ 92.00 801-900 Amp Fee ............................ $105.00 Commercial/Multi-Family and All Upgrades: 901-1000 Amp ................................. $117.00 # of Circuits x $2.00 (~- ~~ IF OVER 1000 Amp Amp Fee 1st 1000 Amp Fee ....................... $117.00 ~° ~~ Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total NOTICE New Residential: (Finished Area) I hereby certify that I have read and examined this Single/Two Family Dwellings application and know the same to be true and correct. All sq. ft. x .045 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 rovisions of an other state or local to violate or cancel the Receptacle/Switch Outlets ~ ~ y p Fixtures _ x $.75 ~ ~ law regulating construction or the performance of construction. Residential/Commercial Appliance # Fixect Outlets x $3.00 Power Apparatus (220 Volts) d # A aratus x $3 00 ~ pp . RE OF CONTRACTOR 0 U HO I E AGENT Permit Issuance Fee ............. $15.00 ~ ~ ~ DATE TOTAL _~ ~ Off` WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT Comment: Approved By: ~l /,~_ POUNDS PRTG.-Blair. NE Rev. 12/95 City of Blair 218 South 1 bth Blair, Nebraska 68008 402-426-4191 Fax - 402-426-4195 ~.' March 1, 1996 WagnE Smith RR 1, Boa 50A Blair, NE 68008 RE: Building Permit #5787 Dear Wayne, On March 31, 1994, you were issued. the above building permit to build an addition onto your home. Your building permit will expire in March, 1996. If you have completed this project, you MUST contact our office at (402) 426- 4191 for a final inspection. If this project is not complete, yvu will need to renew your current permit by March 31, 1996. Please contact our office regarding the status. of this permit.. If you have any questions ,. feel free to contact me. Thank. you for your cooperation in this matter. Sincerely, ~~~~~~- Brenda Taylor Administrative Assistant "~ promise MECHANICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Application Date: ~1 io1 '~ ~/ ~ D ~ Permit Fee: $ JOB ADDRESS ~ l G~ ~G /iY'J LEGAL 1 • DescR. LOT NO. BLK. TRACT O SEE ATTACHED SHEET 2 OWNER ~ ~sw7~ MAILADDR ZIP PHONE r3• CONTRACT R MAIL ADDRESS PHONE LICENSE NO. 4. Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL EMODELING/ADDITIONS O REPLACEMENTS 5• Describe Work: Comments: MECHANICAL PERMIT FEES Forced Air Systems Per Unit Commercial/Residential (New) .............. ........................ $25.00 Air-Conditioner Unit Per Unit Commercial/Residential (New) .............. ........................ $10.00 Refrigeration Units/Coolers Per Unit Commercial (New or Replacement) ...... ........................ $10.00 NOTICE I hereby certify that I have read and examined this Forced Air Systems/Air Conditioner application and know the same to be true and correct. All Unit Replacement ~~ ~ ~~ provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Per Unit Commercial/Residential (Replacement) ........................ $10.00 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. ~~D D Permit Issuance Fee ............. $15.00 TOTAL ~.J~ ~ r~ _ _ SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ~'~Y ~C~ Current License on File O Yes O No O NA DATE WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT- Comment: Approve¢,~y: 1 ~~~ !i POUNDS PRTG: Blair, NE Rev. 12!95 1 ;~v e~~l~ ~/ y a p ~ ~~ ~~ ~ ~ ~ ~ q, ~ o ~ `m b ~ - i ;. ~~. -~pir~do ~. ~ C~ .C~ ~ ~ ~ ~ I ~ ~ -~ e ~ j ~~ ~ z S~/9~ a d P %~ SSi~Y~ -~r~ai7S ~ ~ `~ i 1 f ------~----------- - ~--- --,3 0' ---------- - ~ ~o ~ _... _ -W_- -- ~ ~ S ~ a a ~ o ~ ^ r ^ ~ ^ ^ r ^ ^ ~ ^ ~ ~ ~ a a o~ rr- m m '~ ~ c ~ ~ :o n =o ~ ~ ~ ~ e '~ ~ r ~ m ~ ~ ~ a a ~ o o ~ z ~ z ~ ~ o ~ ~ ~ ~ _ ~ ~ z o m d m ~ -~ ~ ~ r ~~ ~ t" ~ ~ ~ ~ ~ '~ r. ~ ^ ~ ^ ^ ^ ~ a Z ~ ~ _ ~ p n r Ctrl ~ !' ~ ~ ~ '~ ~ ~ ~ ~ ~ z ~ r r„ . ~ z .' ~ ~, ~ ~ ~? m q . 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