BP6518I
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Site Plan Attached [~ Complete Plans Attached ^
Approximate Comp etion Date
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
6518
Application Date: to ` ~'~~ Issue Date: ~ ~ ~ ~ Permit Fee: $ ~Q -~~
J08ADDRESS ~ ~~
c~rK
LEGAL
1 ' DESCR. LOT NO. BLK. TRACT
^ SEE ATTACHED SHEET
2 OWNER MAIL ADDRESS ZIP PHONE
m ~ ~'n~
3. CONTRACTOR ~ m cJ r ~2~ r MAILADDRESS ~ ~ ~.1~ ~~ PHONE ~~~ _ ~~~LICENSE NO.
(_7(
USE OF BUILDING
4.
5. Class of Work: NEW ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ ~ X Z ~(, (Z,~~- ~ (J(~ ~~'~~_
7. Sq. Footage of Structure (IndudiRg BesemeRt>,Ra Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $ ~~ Q ,
10. Floodplain: Floodway Yes ^ No ~
Fringe Yes^ No ^~- Dev. Permit Elev. Cert.
BFE
11. Current Zoning: ~ N2 l°{'
12. State Fire Marshall Required: Yes ^ No~
13. Special Use Permit Required: Yes ^ No ^~
14. Variance Required: Yes ^ No ®~
15. Minimum Setbacks: Front L~Side _~ Rear
16. Sidewalk Required: Yes ^ No ^ Waiver Approved
BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY
NOTICE
Separate pe its 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 setforth
above and in accordance with the codes~ordinances of the Ciry of Blair and the State of
Nebraska. I understand that this permit is void if work is not commenced within 180 days
or is not completed within 2 years of date of issue.
SIGNATURE OF OWNERJCONTRACTOR OR AUTHORIZED AGENT DATE
SIGNATURE OF OWNER (IF OWNER BUILDER)
DATE
Sewer Water Service
Septic Remote
3-g-~(~ S`F~I w6r Inq
Building
Footings ~ ~`~~~ D all ~
(before finish)
Framing a~~`~(~~ Final f ~ ~~~-~~
Electrical
~~ ~ ~` Zi-q S°
Rough-in ~ S f (f'c~~ ~ Fixtures
Final ^~ `°' Permanent Service
Temporary Service
~-5-y~ Mechanical
Rough-in ~ !Y~c~-~v~, ABC ~Ldv~
Final ~- ~
Plumbing
Ground Work
Permit
Final
Rough-in _
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approv d B6•
°OUNDS PRTG: Bleb, NE Rev. 709'
CATION
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~~~~~~
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
CATIO\1V
6598
Permit
oa
Application Date: ~ ~ ~ (~ ~~~ Issue Date: Permit Fee: $
JOB ADDRESS I ~ ~ ~ W V ~ ~~
LEGAL
1, DESCR. LOT N0. BLK. TRACT ^ SEE ATTACHED SHEET
2, OWNE ~ I
W\ ^ MAILADDRESS ZIP PHONE
I~
3, CONTRACTOR ~~ MAILADDRESS ,~^ ~ PHONE I`7).'~-(plf2-Z~$1 LICENSE NO.
~ ~ -~l^J
USE OF BUILDING
4.
5. Class of Work: EW ^ ADDITION ^ALTERATION ^ REPAIR ^ MOVE ^ REMOVE
6. Describe Work: ~ J ~~ ~~~~~ ~,~,
], Sq. Footage Of StrUCtUre (Including Basement and Garage):
8, Change of Use From: Change of Use To:
g, Valuation of Work: $
10, FIOOdplaln: Floodway Yes^ No ~ Dev. Permit
Fringe Yes^ No ^ BFE EIev.CeA.
11. Current Zoning:
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 ^ Waiver Approved _
APPLICATION ACCEPTED 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 herebyagree to perform the proposed work in accordance with the specifications setforth
above and in accordance with the codes~ordinances of the City of Blair and the State of
Nebraska. I derstand that thisis pe It' void if~w~or/k~is not commenced within 1 SO days
or feted withi~a / of iss~ l"/
d `3
SIGNATURE OF
AGENT DATE
Site Plan Attached ^ Complete Plans Attached ^
Approximate Completion Date ~.~ 10 ~ q 5
Inspections Required and Fees
Utilities
Sewer Tap Water Tap
Sewer Water Service
Septic Remote
Building
Footings Drywall
(before finish)
Framing Final
Electrical
D~
Rough-in (~ Fixtures
Final ~ ~~ Permanent Service
Temporary Service
Mechanical
Rough-in ABC
Final
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG: Blalr, NE Rev. 10~et
BUILDING PERMITAPPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~ /D -~.~ Issue Date:
Permit
6594
aJ
Permit Fee: $ ~~~-
JOB ADDRESS
LEGAL
1 LOT N0. BLK. TRACT
^ SEE ATTACHED SHEET
' DESCR.
2. 0 ER / / MAIL D~ESS ~ ~G2'~'-~~~ ZIP
~ ` ~~ ~ P~ E ~..~.
MAILADDRESnL
~ONE
3. CONTR CTOR ~ I~~~O~
~ ~
Off' L -
~~P 4+
USE OF ILDING
4. r~
5. Class of Work: ANEW C ^ ADDITION ^ ALTERATION EP IR ^ MOVE ^ REMOVE
6. Describe Work: ~ ~r ~ ~ ~~ ~~~,
7. Sq. FOOtage Of StrUCtUre (Including Basement and Garage):
$. Change of Use From: Change of Use To:
g, Valuation of Work: $ ~°(~~j~ ~
Floodway Yes^ No ~
10
Floodplain: Dev.Permit
EIev
Cert
.
FriBge Yes^ No ^ BFE .
.
11. Current Zoning:
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 ^ Waiver Approved
APPLICATION ACCEPTED 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 by the 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 understand that this permit is void if work is not commenced within 180 days
or is not completed within 2 years of date of issue.
SIGNATURE OF OWNERfCONTRACTOR OR AUTHORIZED AGENT DATE
7~
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
(before finish)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Rough-in ~ Mechanical
C ~~ ` C7Q
A
B
Final ~ ~ ~ /~ ~ ~ l~ °
Plumbing
Ground Work
SIGNATURE OF OWNER (IF OWNER BUILDER) ~ DATE Rough-In Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved~y:-~
v„~
CATIO~IV
POUNDS PRTG: BIeU, NE Rev. 1091
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