Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
P19971002
PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 ~ (402) 426-4191 Application Date: l 0 4 "~~ ll ~b Permit Fee: $ ~J JOB ADDRESS - ~ _ GAL 1. DE LOT N0. BLK. TRACT O SEE ATTACHED SHEET 2.OWNE MAILADDRESS ZIP `ON ij~ 3. CONT MA1L ADDRESS L ~ ~0~~ J LICE(JSE N0. 1 o~ / l~ ~ti/ 4• Class of Work: O NEW RESIDENTIAL O N COMMERCIAL O REMODELING/ADDITIONS D REPLACEMENTS 5• Describe Work: Comments: PLUMBING PERMIT FEES Type of Fixture No. Kitchen .................................. $8.00 x Bath ....................................... $8.00 x Rough-In Bath .......................$4.00 x Utility ..................................... $5.00 x Water Heater ......................... $3.00 x Outside Water Faucet ........... $3.00 x Water Service ........................ $10.00 Q a rz , NOTICE Sewer .................................... $10.00 hereby certify that I have read and examined this Groundwork ...........................$10.00 application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Septic Tank & Laterals .......... $10.00 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority Lawn Sprinkler System .......... $10.00 to violate or cancel the provisions of any other state or local Sprinkler System ...................$30.00 law regulating construction or the performance of construction. (Commercial) ~ , Permit Issuance Fee ............. $15.00 dU ~ GNATURE OF CONTRACTOR OR AUTHO IZED A NT TOTAL ~~ ~~-S DATE Current License on File OYes O No O NA WHEN PROPERLY VALIDATED (IN THIS SPA(3E~THIS IS YOUR PERMIT POUNDS PRTG.•Blalr, NE Rev. 12/95 ~~iNG INS~'ECTI~N R,EPOI~,T - t „~,-Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHI~ /-.,; LOCATION OF INSPECTIONS /~/ ` r / ~~ ~ j / ~ ~ I NAME OF OWNER,: G~-~ _ CONTRACTOR: '~~`~ %~~ ~ DATE INSPECTION REQUESTED: - FRMI 0: TIME INSPECTION REQUESTED: ~ ~ ~ TYPE OF INSPECTION REQUESTED: BUILDING: ^ FOOTING ^ FRAMING ^ DRYWALL ^ FINAL UTILITIES: ^ SEWER TAP ^ SEWER EPTIC _ ATER TAP ~ ( ' ^ REMOTE [WATER SER V I CE ELECTRICAL: ^ R©UGH IN ^ FIXTURES ^ FINAL ^ MOTORS ^ PERMANENT SERVICE ^ TEMPORARY SERVICE MECHANICAL: ^ ROUGH-IN ^ A/C ^ FINAL :: PLUMBIN(~~` ^ GROUNDWORK ^ ROUGH-IN ^ FINAL RESULTS OF THE INSPECTION~t-'xbS~D (sue NorES~ ^ FAILED csEE No~rns> NOTES/REMARKS: DATE OF INSPECTION u~~: CALLED OPPD\ TO CONNECT SERVICE: WANT OFFICE STAFF TO CALL OPPD\ ^ YES ^ NO ^ YES ^ NO BLR 1