Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
BP7066
BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Permit 7f~~G ~~~ ~ Application Date: /~~~D `~ ~° Issue Date: ld ~/l~ ~ ~ ~ Permit Fee: $ ...~d ~,~ ~~ JOB AD2, S~ JJ v l I Cj u~ C ~ l Cl t Y' ~ ~ C~ V LEGAL 1 ' DESCR. LOT NO. B~• TRACT ^ SEE ATTACHED SHEET 2. ONE t ~ ~ 3 ~s~ v~r~ MAILADDRESS ZIP ~ PHONE 3. CONTRA ` ~ n , ~OZ..) ` ~ Q M'IL ADDRES ~ ~ ~ ~~ ONE/ ~ ~ ~ LICENSE No. Cs 4. USE OF BUILDING 5. Class of Work: ~ EW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~®v ~ c ~ ~ ~ ]. Sq. Footage Of StrUCtUre (Including Basement and Garage): 8, Change of Use From: Change of Use To: g, Valuation of Work: $ ~+~- ~~ O ©9 , l9 ~ 10. Floodplain: Floodwey Yes^ No Q Fringe Yes^ No ^ Dev. Permil BFE Elev. Cert. 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 acknowledge that payment of the building permit application fee does notconstitute issuance of this building 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 Inspectorand stamped 'APPROVED'. I hereby agree to perform the proposed work in accordance with the specifications setfolih 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, is not completed within 2 years of the date of issuance, or if work is abandoned for six (6) months or longer, whichever is earliest. OF OWNERICONTBACTOR OR Site Plan Attached ^ Complete Plans Attached ^ Approximate Completion Date ~1 ~ ~ - 9 ~~ Inspections Required and Fees Utilities Sewer Tap Water Tap Sewer Water Service Septic Remote Building Footings Drywall (before finish) Framing Final ~ D~-~~ ~~ Electrical Rough-in Permanent Service Final Temporary Service Mechanical Rough-in ABC Final DATE I j 4 Plumbing ~ ! ~d -/D ~ 9~P Ground Work I ATURE OF WNER (IF OWNER BUILDER) DATE Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: ~ ! POUNDS PRTG: Blalr, NE flev. OBrB5