BP8858The City of Blair Building Permit Detail
Permit #: 8858 Issued: 05/04/200p
Completed: 05/24/2000
Location: 245 So 22nd Street
Owner: Crowell Memorial Home
Address: 245 So 22nd Street
Blair, NE 68008
Phone: 402 426 2177
Section: Township: Range:
Subdivision: Lot:
adding a picnic shelter 16 x 20 with concrete floor and no electrical
Contractors
Crowell Memorial Home
General Contractor
Remarks
Type: Miscellaneous building permits
Valuation: $6,000.00
Permit Fee: $50.00
Issue Fee: $15.00
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
05/24/2000 DEM Final Inspection of Project Pass
BUILDING PERMIT APPLICATI®N
~~ ~ w ~ Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: `~ ~ Blair, Nebraska 68008
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit $ a 5 8
Deposit Receipt #:
Issue Date: 5'~ _ ~ o Type: _ ~7 " ~f ` ~d
JOB ADDRESS
S
LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
W
~~ ~ DDRESS Zlp HOME PHONE L~/ ~~
WORK/CELL PHONE /
CONT
`3, MAIL ADDRESS ZIP HOME PHONE
WORKICELL PHONE
4. Class of Work: ^ NEW ADDITION Q REMODEL ^ OTHER Q FINISHED BASEMENT Q UNFINISHED BASEMENT
5. Describe Work: C(.1~1 1 ~ r ~' ~
~~ ~ -P C
6. Valuation of Work: $ Total Sq. Footage (IRCluding BasemeBtaRd Garage): Total Finished Area:
Floodway O Yes
7. FIOOdplain: Fringe O Yes o Dev. Permit
o BFE Elev. Cert.
8. Current Zoning: ~ ~~
9. State Fire Marshall Required: Q Yes Q; No
10. Special Use Permit Required: Q Yes /~No
11. Variance Required: O Yes [~IGo 0
i
12. Minimum Setbacks: Front ~~ 1 Side ~_ Rear ~_
13. Sidewalk Required: Q Yes ~No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septic systems. By my signaturebelow, I acknowledgethat payment
of the building permit application fee does not constitute issuance of this building
permit. I further agree that construction covered bythis permit application shall not be
commenced until I have received a copy 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. l understand thatthis per~r~j it is void if work is not commenced within
180 days ar is not completed within 2 vearstof date of issue. i
OF OWNER/CONTRACTOR
Comment:
~~~~`-
^ Site Plan Attached /' D C~ ~te Plans Attached
Approximate Completion Date C~ - /
Inspections Required and Fees
Utilities
Sewer Water Service
Septic Remote
Stop Box Card
Buil in
/
FootjAgq~
Drywall
(PRIOR TO TAPING)
Fr ~g
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A1C ,
Final
Plumbing
Ground Wark
Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THis IS YOUR PERMIT
Rev. B/96
POUNDS PRTG.-Blatr, NE
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~`"°'Blair
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.
Owner/Occupant
Contractor
_~ ~
Date
218 S.16TH STREET, BLAIR, NE 68008.2010 • (402) 426.4191 • (402) 426.4195 FAX • E-MAIL: cityotblair@huntel.net
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16" DIA. CONC, FOOTIIJG
F - - -- - - --- -- --- -- - - --- -- - - - ------ -- -- _ -- -
~~~- UILDING INSPECTION REPORT
CTI'1' OF BI;AIR ^ WASHINGTON COUNTY ^ OTHER ~ :~~~~~~
f
LOCATION OF INSPECTION: !~ ~-~ . ~ -~~~ ~ ~~~ ~ ~~~~
y~~ -
NAME OF OWNER: ~~~' ~'~~-~.~-~~ CONTRACTOR:
DATE INSPECTION REQUESTED: ~ ~'"°C;'~ pERMITNO: l~_~r~
TIME INSPECTION REQUESTED:
TYPE OF INSPECTION REQUESTED:
BUILDING:
^ FOOTING ^ FRAMING ^ DRYWALL ~] FITfAL
r
UTILITIES:
^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP
r
€. ^ REMOTE ^ WATER SERVICE
~ ELECTRICAL:
^ ROUGH IN _ ^ FIXTURES ^ FINAL ^ MOTORS ~ - '
Q PERMANENT SERVICE ^ .TEMPORARY SERVICE
,~
MECHANICAL: I
- ^ ROUGH-IN ^ A/C ^-FINAL .
~', ~ PLUMBING: _
-{_} GROUNDWORK---_-__._..:.: ^ROUGH-IN __._^ FWAL----- ----------_--
RESULTSOF.THEINSPECTION: _ 3 PASSED'~s~-rioi~s~ ^FAILED~s~xo~s>
NOTES(REMARKS: ~~
,,
- ~~f~~`
DATE QF INSPECTION MADE; ~ ~ ~/'j~ ;; - ~E; ~ ~~
. ~
f CALLED OPPD\ - TO CONNECT SERVICE: ^ YES
I
. ~ I _~. .WANT OFFICE STAFF TO CALL OPPD\ ^ y~
.. ,_
^ NO
^NO - 6LR 1