Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
BP7459
BUILDING PERMIT APPLICATION Permit Fee:©,o-o Jurisdiction of City of Blair, Nebraska 218 South 16th Street Issuance Feer© Blair, Nebraska 68008 � Deposit Receipt #: /'7 (402) 426-4191 - Fax (402) 426-4195 Permit -7459 Application Date: 10 — / 4 19 Ca Issue Date: to - l Ll-*(' JOB ADDRESS LEGAL 1. DESCR. LOT N0. BLK. TRACT 13 SEE ATTACHED SHEET OWN 2. C vT MIL ADDRESS off` ZIP PHONE CONTRACTPR 3. . �, MAIL ADDRESS / � � 76'D�- ZIP PHONE 4. Class of Work: O NEW O ADDITION O REMODEL 5. Describe Work: ' O Finished Basement O Unfinished Basement 6. Total Sq. Footage (Including easement and Garage): Total Finished Area: 7. Valuation of Work: $ Floodway O Yes O No 8. Floodplain: Fringe O Yes O No Dev. Permit BFE Elev. Cert. 9. Current Zoning: 10. State Fire Marshall Required: O Yes O No 11. Special Use Permit Required: O Yes O No 12. Variance Required: O Yes O No 13. Minimum Setbacks: Front Side Rear 14. Sidewalk Required: O Yes O No Waiver Approved. NOTICE 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. 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 1800 d r is not complet within 2 years of date of issue. SIGNATURE OF 0 ER/CONTRACTOR DATE Comment: O Site Plan Attached O Complete Plans Attached Approximate Completion Date 0-1414 Inspections Required and Fees Utilities Sewer Septic Building Footings . Framing Electrical Rough -in Final Temporary Service Mechanical Rough -in _ Final — Plumbing - Ground Work Rough -in _ Water Service Remote Stop Box Card Drywall (before finish) Final (� 7 Fixtures Permanent Service — XC Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT A/ppp�'ro/XE dd BY: y POUNDS PRTG.•Blair, NE Rev. 8196