Loading...
BP8420p~ ~~ Io65~ x_31-91 The City of Blair Building Permit Detail Permit #: 8420 Issued: 03/15/1999 Completed: 08/30/1999 Owner: Kirk & Gail Conyer Address: 10219 Co Rd 29 Blair, NE 68008 Phone: Section: Township: Range: Subdivision: Lot: pole shed 40x40x10 for storage, concrete floor Inspections Date By 08/30/1999 KAR Remarks Type: Pole Barn/AG Barn Valuation: $17,000.00 Final Inspection of Project Permit Fee: $85.00 Issue Fee: $15.00 Deposit Amt.: $200.00 Receipt #: 9413 Block: Pass Contractors Jorgensen Contracting, Inc. General Contractor Permit # Issued ~~ BUILDING PERMIT APPLI Permit Fee: ~`~ +C~~ ~ ~ Jurisdiction of City of Blair, Nebraska war DO 218 South 16th Street Issuance Fee: ~ b Blair, Nebraska 68008 Deposit Receipt #: ~ ~ ~ (402) 426-4191 ~ Fax (402) 426-4195 Plumbing - Ground Work Rough-in Application Date: ~ - ~~ _ ~ ~ Issue Date: ~ `~~~ ~ 9 JOB ADDRESS ~ ~ ~, ~ ~ ^ ("I LEGAL 1 . DESCR. LOT, ~ ~~ BLK. `` I ~' I ( ~ I TRACT ^ SEE ATTACHED SHEET OWNE MAIL ADDRESS 2. `~it~ k. } ~ 1 r SC~M~ ZIP PHONE ~~ In - ~79~ CONTRACTOR MAIL ADDRESS s. ) ergs ~=~~-~r ~~~ ZIP PHONE ~~~ ~+a -tom -~ ~F ~~ U 4. Class of Work: NEW O ADDITION REMODEL _ 5. Describe Work: X11 Z-~.(~' x x ~ ' ~.- O Finished Basement O Unfinished Basement ~~ \ u`( ~ ~ , ~'~,~~ 6. Total Sq. Footage (IRCIBdiRg Basement and Garage): Total Finished Area: 7. Valuation of Work; $ Floodway O Yes No Dev. Permit 8. FIOOdplain: Fringe O Yes No BFE Elev. Cert. 9. Current Zoning: ~'~ 10. State Fire Marshall Required: O Yes ~ No 11. Special Use Permit Required: O Yes ~No . 12. Variance Required: O Yes O No 13. Minimum Setbacks: Front-~ Side ~~ RearS~ 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 acopy of this application form signed by the Building Inspector. 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 J~days or is not completedw,ithin 2 years of date of is,~ue. ~~ Comment: O Site Plan Attached O Compl to laps Attached Approximate Completion Date 3 - / « -- ~~ Inspections Required and Fees Utilities Sewer Septic Building Footings Frar~-in~ Electrical Rough-in Final Temporary Service Mechanical Rough-in _ Final MEET UBC, UPC, UMC ANQ NEC CODE AEQUlREMENTS Permit 8 4 2 0 Water Service Remote Stop Box Card _ Drywall (before finish) Fixtures Permanent Service A1C Final WHEN PROPERLY VALIDATED (IN THIS By: ~~l CATION ~~~ YOUR PERMIT POUNDS PRTG: Blair, NE Rev. 8/96 o~ ~, ®~ ~~~ city ~fBlGll y' BUILDING PERMIT SUPPORTING DOCUMENTS This building permit packet includes various items dealing with particular code requirements and/or building permit requirements. It in no way includes ALL particular code items. Also, it is your responsibility to know the Uniform Building Code requirements that apply to your project. Please understand this packet is only designed and distributed to aid you in your building permit process. The Uniform Building Code is available for your use at the Blair Public Library. I have read the above disclosure and accept this building permit documentation on my own behalf assuming full responsibility as the owner/contractor for this project. Contractor City o Blair ~o t~ Date 210 ~.16TII ~TItEET, ELAN, NE 6~000~2010 ~ (402) 4264191 ~ (402) 42641951i'AR a E~P~AIL: cityotblair@huntel.net ~~a oaroxroHm ~-~ `9 pr®mise O~ ~ promise ~, ~` J~ 0. City of Blair 218 South 16th Blair, Nebraska 68008 402-426-4191 Fax - 402-426-4195 BUILDING PERMIT DEPOSIT AGREEMENT A $200.00 refundable deposit is being collected at the time of your building permit application for all permits in excess of $10,000.00. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: 1) water is connected without a meter by either the plumber, owner or general contractor, 2) all required inspections have not been obtained (this includes drywall prior to taping) as per attached checklists (Both Rough-In and Final), 3) occupancy or utilization occurs prior to a final inspection, and 4) all permits have not been obtained. If any or all of these situations occur during construction, you may forfeit your deposit. I, hereby agree to the above conditions, and understand that should any or all of the above situations occur, the building permit deposit may be forfeited or discounted upon the discretion of the City of Blair, Building and Inspections Department. ~~f~--~~ Date Contractor/Owner ~~ 1/~/ City o lair EGU~LNW4NG ovvoaruNm ~ . BUILDING INSPECTION REPO ,; , . RT i • ~/ I, CITY OF BLA1R ~ WASHINGTON COU NTY ^ OTHER i LOCATION OF INSPECTION: ~~!1; Lf ~ ~ ~ {,r,-;~ NAME OF OWNER: ~r~ ~ ~;_; t ,,r--. - ~ - CONTRACTOR: ~.rc;;~~;j„,-,~ DATE INSPECTION REQUESTED: ~ ~ ~ ~- ~ ~ `l PERMIT N0: ~~~ Ci TIME INSPECTION REQUESTED::~~I .= Y`,7 ~, -- '~J TYPR OF INSPECTION REQUESTEDc BUILDING: I ^ FOOTING ^ FRAMING ~ DRYWALL ~C~FINAL UTILITIES: ^ SEWER TAP ^ SEA ~ SEPTIC ^ WATER TAP Q REMOTE ^ WATER SERVICE ' ELECTRICAL: ^ ROUGH IN ~ FIXTURES ~ FINAL ~ MOTORS Q PERMANENT SERVICE 0 TEMPO~Y SERVICE MECHANICAL: ^ ROUGH-IN ^ A/C QFINAL PIiUMBING: i ^ GROUNDWORK ~ ROU~{N 0 FINAL RESULTS OF THE IVOTFS/REMARKS; '- INSPECTOR: ED (sue-xoTES~``~ .FAILED (s~x~I ., ~~. llATE OF IlVSPECTION.MADE: °' "TIME• _ ' CALLER OPPD\ TO CONNECT SERVICE: _ ^ YES (~ NO WANT:OFFICE STAFF TO CALL OPPD\ -- - -- - - -------_-=- ---- ------- ~ YES_ C~ NO BLR 1 9 ~~` l,~i~ C~©~r.~s r ,~oT so `D~2/9 C~r~` ~d .~ js i~- ~i ~(aXyox/o' ~/~irP ~, 6gooA' Ps,~~ dr~a ~o~ /~~G - a79s ~ Co,~c~QIE F,~eoe dal ~dj P~,v /~'(~Pl~ f{/,~ /iP~c ~Ic~od -~ ,,P!lSS. (d~A~( II9,~'I/1~ ~D' .?,YG ~/klJ 1~0~0 Cap u~u 1 I . ~'~,~/I~rIE sAA,6 ,~lZ~~'rtii~ve = r~/m cv,~e,~re ~~ ~l'~l/D~1 .D~'ji¢/~ ~~ 4 -'~ ~~ Q . ,,, deSf ~~ ~ ~MM L/1 x ~~ ~~ ~ ~ ~~~~° ~ ~ p 3< ~4~ ~ _-~' o r V < a s o~ ~'3 f: ~e ~ ~~ -~ 0 ,a 4 i 0 f~ Q ~~ ~~~ XNphl le Tey M MIW ~ax9' izx y- i®' ,~~ .~: ~~ B ~ ~~~~ ~9