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BP7116BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 7116 (402) 426-4191 Permit Application Date: 44 -10-9(o Issue Date: 1� —11 - 1 W Permit Fee: $ /00, Coo JOB ADDRESS f� lJ N Complete Plans Attached ❑ LEGAL 1' DESCR. LOT NO. BLK. TRACT ❑ SEE ATTACHED SHEET 2 OWNER PCS-� ne1� MAILADDRESS ZIP �-t PHONE CONTRACTOR MAILA DRESS PHONE 3' F( Cr �2ruiC.O� C0(ra`�un qv7 S 2-7`x'' i4W- LICENSE NO. dmc-f�a � / 4. USE OF BUILDING L1 4l, 1 Joe A0 f K c f07 -_ -3446.W,?,— 5. Class of Work: El NEW ❑ADDITION❑ALTERATION [REPAIR ❑ MOVE _]REMOVE 6. Describe Work: Drywall 7. Sq. Footage of Structure (Including Basement and Garage): S�Lr (before finish) 8, Change of Use From: Change of Use To: C. 9, Valuation of Work: $ -z-5 UC)O , 0 Floodway Yes ❑ No E:3Dev. Permit 10 Floodplain: Fringe Yes No [IBFE EIev.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- BY pproved_ BY I PLANS CHECKED BY [ t y v 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 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 copyof this application form signed by the Building Inspectorand stamped 'APPROVED'. I hereby agree to perform the proposed work in accordance with the specifications set forth above and in accordance with the codestordinances 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) mo r I ng , isearliest. 04ATLIFIE OF OWNER/CONTRACTOR OR AUTHORIZED AGENT DATE 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 Permanent Service Final Temporary Service Mechanical Rough -in AkQ Final Ground Work Plumbing SIGNATURE OF OWNER (IF OWNER BUILDER) DATE I Rough -in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: POUNDS PRTGAlelr, NE Rev. 06195 ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 0278 (402) 426-4191 Permit Application Date: q 10"c -I Permit Fee: $ JOB ADDRESS 1 7DE LOT N0. BLK. TRACT 17 SEE ATTACHED SHEET 2 OWNER 1n' � {-� (�(' AILADDRESS '/ /� 1 1.1 a Y �1�11 I �V13 vil!�S , ^ZIP C( "! - X/ 0-) PHONE / (V6 33 CONTRACTOR MAIL ADDRESS PN NE mldcon Hr -C40 -11c' ---It (n -7 6 Z- c)& -e - h 1) r LICENSE NO. 4. Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE 5. Describe Work: �F( ire, Ocur1 12z 1 6• Current License on File ❑ Yes O No O NA New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES 1-100 Amp Fee ............................$ 13.00 Upgrade Existing Service ...... $10.00 101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00 201-300 Amp Fee ............................ $ 30.00 ............................ 301-400 Amp Fee $ 42.00 Fire Alarm System ................. $10.00 401-500 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 Am 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 to violate or cancel the provisions of any other state or local Receptacle/ witch Outlets Fixtures x $.75 law regulating construction or the performance of construction. Residential/Commercial Appliance # Fixed Outlets x $3.00 Power Apparatus (220 Volts) # Apparatus x $3.00 SI URE OF CONTRACTOR OR AUTHORIZED AGENT -�r h h z� Permit Issuance Fee ............. $15.00 S 0 DATE TOTAL �S - Cab WHEN PROPERLY VALIDATED (IN THIS SPACE) THI" YOUR PERMIT I Comment: I Approved By: e � POUNDS PRTG: Blair, NE Rev. 12/95 I I promise Paula Welch 631 N. 15th St. Blair, NE 68008 Dear Ms. Welch, City of Blair 218 South 16th Blair, Nebraska 68008 402-426-4191 Fax - 402-426-4195 April 1, 1.996 It has been brought to our attention that your home received. fire damage several weeks ago. _ Please be aware that before doing any construction or�repair work to your residence, you will need to obtain a building permit. You will also need to contact the City Building Inspector, Dale Miller, no later than Friday, April 12, 1996 to discuss any building construction being done on your home. Thank you in advance for your prompt attention to this matter. Sincerely, Rodney A. Storm City Administrator RAS/bt 13