BP8295Q~ g_II_c~~ ~~ I ~3gz-
The City of Blair Building Permit Detail
Permit #: 8295 Issued: 09/14/1998 Type: Residential -New Construction
Completed: 07/19/1999 Valuation: $120,000.00
Owner: Marvin Daniels Permit Fee: $555.00
Issue Fee: $15.00
Address: 1326 Corey Drive Deposit Amt.: $200.00
Receipt #: 08129
Blair, NE 68008
Phone: 426-5847
Section: Township: Range:
Subdivision: SUGAR GROV Lot: 2 Block: .
Ranch, 3 bedroom, 2 1/2 bathroom, 2 car attached garage, rear deck 8'x40', unfinished basement, 3324 total
footage, 1840 finished footage
Inspections Date By
09/29/1998 KAR Footings Pass
10/07/1998 DEM Electrical Temporary Service Pass
12/04/1998 DEM Plumbing Groundwork Pass
12/18/1998 KAR Sewer Lines Pass
12/18/1998 KAR Water Service Pass
02/0311999 KAR Plumbing Rough-ins Pass
02/03/1999 KAR Framing Pass
02/03/1999 KAR Electrical Rough-ins Pass
02/03/1999 KAR Electrical Permanent Service Pass
02/03/1999 KAR Mechanical Rough-ins Pass
05/19/1999 DEM Mechanical Rough-ins Fail
05/19/1999 DEM Plumbing Rough-ins Fail
05/19/1999 DEM Electrical Rough-ins Pass
05/19/1999 DEM Mechanical Rough-ins Pass
05/19/1999 DEM Plumbing Rough-ins Pass
05/19/1999 DEM Electrical Rough-ins Pass
06/03/1999 DEM Drywall Pass
07/19/1999 DEM Plumbing Final Pass
07/19/1999 DEM Final Inspection of Project Pass
07/19/1999 DEM Electrical Final Pass
07/19/1999 DEM Mechanical Final Pass
Remarks
Contractors
Bauer, Rodger K. General Contractor Permit # Issued
Dick's Electric Co. Electrical Subcontractor 0539 10/06/1998
The City of Blair Building Permit Detail
Henton Trenching, Inc. Plumbing Subcontractor 0136 12/17/1998
Mallory Plumbing & Heating Plumbing Subcontractor 0122 12/02/1998
Mallory Plumbing & Heating Heating Subcontractor 0287 12/02/1998
~ ~ ~~If ~- ~-~-~ JNa~~in L~cf'1U11S / Dia~~s 1~; C/LS
~.
UILDING PERMIT APPLICATION
~9 - - Jurisdiction of City of Blair, Nebraska
Permit Fee: ~ -~~-~' 218 South 16th Street
Issuance Fee: I ~-~~~ ~ ~~ _ ~~~' Blair, Nebraska 68008 8 2 9 5
Deposit Receipt #: C~ ~ (~ ~1 ~' (402) 426-4191 ~ Fax (402) 426-4195 Permit
Application Date: C_ ~ ~ f ~ ~ Issue Date: -
J08 ADDRESS / ~ ~ / ~
l~ /~Ct r ~? \
(~ ~ ~ 1 Y
LEGAL
1. DESCR. LOT NO. ~ BLK. TRACT ~ v v ~~,
~~~ V'~ ^ SEE ATTACHED SHEET
OWNER
2. ~IC1f I11 -
GL D MAILADDRESS
13~~_~j _-~It(~ ZIP PHONE
~S'~ Z ---
CONTRACT
3. ~C~~c ~_(~ ~ Gl~~_(' MAIL ADDRESS
1Q~ ~ f _~~L\'F ~1 ~ ~ . ZIP PHONE
~~1~I ~ y~lcs ,~ I_3~
4. Class of Work: ~l NEW O ADDITION O REMODEL
5. Describe Work:
~,~~,
- t~~,nc.h
- ~3) ~Cjec~Jr~~~S. ~ ~'t~hr Fln'
Z ~z ~hed Basement nfinished Basement
I~eCQ~Qor,^,
6. TOtal Sq. FOOtage (Including Basement and Garage}; ~-j ~ Total Finished Area: ~ ~f~;~
7. Valuation of Work: $ I _ ~ C
Floodway O Yes
8. Floodplain: Fringe O Yes ,0''No
No Dev. Permit
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 ~ No
13. Minimum Setbacks: Front :~ S Side ~_ Rear
14. Sidewalk Required: l~Yes O No Waiver Approved .
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septicsystems. By mysignature 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 bythe 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 thatthis permit is void if work is not commenced within
180 days or is nQt completed~hin 2 years of date of issue.
SIGNATURE OF 0 ER/CONTRACTOR DATE
Comment: ~/9.t~~~ ~/l
C~ /~ •6 ~1-J7
B~~ ~
Ite Plan Attached -'Complete Plans Attached
A proximate Completion Date ~' ~ °I °i
Inspections Required and Fees
Utilities
Sewer
Septic
Buildin
Footings 4~'~~~~?~~1
Framing
Water Service
Remote
Stop Box Card
Drywall rn~C~~-~
(before finish)
Final
Electrical ~ i C K, ~ ~ ~ ~ C'~rr
Rough-in
Final
Temporary Service
Fixtures
Permanent Service
Mechanical ~`~~tC_~tY~ 1`~Cn,~~O'~LI
Rough-in A1C
Final
II
Plumbin ~" G1 ~I C. ~~/ ~ ~ ~~ . _ __
Ground Work
Final
WHEN PROPERLY VALIDATED (IN T1~hS SPACE) THIS IS YOUR PERMIT
POUNDS PRTG: Blair, NE Rev. fl58
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: `~ _~
V•O~
Permit Fee: $
JOB ADDRESS / ~ I f1
1. OWNER ~ MAIL ADDRESS
~lli Y~ l ~ ZIP PHONE
2. CONT MAILADD E
~ ~- ONE
P
~ LIC SE NO.
3• Class of Work: O CO ~ MERCIAL O RESID TIAL NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4• Describe Work:
Comments: PLUMBING PERMIT FEES
Modular Home ...................... $15.00
Type of Fixture No.
~
~`~~
...........................
Kitchen $8.00 x
....... /
~~/•oV
Bath ................................ ....... $8.00 x
/ ~~ ~~
g ................
Rou h-In Bath $4.00 x
.......
Slop Sink/Laundry Tray ..
....... $5.00 x
~- 5
/ ~o
~ 3
VO
Water Heater .................. ....... $3.00 x r
~ ~ ` ~~
Outside Water Faucet .... ....... $3.00 x
Drinking Fountain ........... ....... $3.00 x
Water Service ........................ $10.00
NOTICE Sewer ............................. ....... $10.00
~ //11
/y' ~ ~
I 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. Lawn Sprinkler System .. ....... $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local Sprinkler System ............ ....... $30.00
law regulating construction or the performance of (Commercial)
construction.
Gas/Water Piping System
(Commercial) .................... ........ $30.00
~~ ~ ~
Permit Issuance Fee $15.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
TOTAL Q' '~
~J Q • Uri
~
r~~~
~
DATE Current License on File t es O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPACE)
Comment:
Approved By:
S IS YOU~i PERMIT
P 0122
POUNDS PRTG: Blair, NE ~~ C ~~ ~ Rev. M98
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 ~ 2 ~ 7
Fax (402) 426-4195 M
(402) 426-4191
Application Date: ' ~ - ~ -~
Permit Fee: $
~o.oo
JOB ADDRES~ ~ ~ r
1 . OWNER AIL ADDRESS ZIP
J PHONE
~
,~. C R \ ~M IL DRESS ~ ~~~ n PHt~ ~ ~ ~ LICENSE NO.
3. Class of Work: O OMMERCIAL ORE IDENTIAL O NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4• Describe Work:
Central A/C ~ Tons MECHANICAL PERMIT FEES
Furnace ~ ~ BTU/H Forced Air/Heat Pump Systems -Per Unit ~~~
Commercial/Residential (New) .................................................... $25.00
# of Units A/C
Air-Conditioner Unit -Per Unit ~~,0
Furnace Commercial/Residential (New) .................................................... $10.00
Forced Air Systems/Air Conditioner
Completion Date:
Unit Replacement Per Unit Commercial/Residenti
al ................... $10.00
Refrigeration Units/Coolers/Lines/Compressor -
Comments:
Per Unit Commercial (New or Replacement) ......
..................... $10.00
Appliance Vent/Fans ...............................$10.00
Boiler .......................................................$15.00
D
S %D.0 ~
uct
ystem ............................................ $10.00
Gas/Air Outlets .................. x $2.00
NOTICE Radiant Heat Systems ............................ $25.00
I hereby certify that I have read and examined this
application and know the s
t
b
t
d
ame
o
e
rue an
correct. All
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
Modular Home ......................................... $15.00
The granting of a
ermit does not
res
t
i
th
it
p
p
ume
o g
ve au
or
y
to violate or cancel the provisions of any other state or local /~
law regulating construction or the performance of
Permit Issuance Fee ............................... $15.00 ,
construction
.
TOTAL
D• ~~
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
~~ ~-' ~- ~' ~~ Current License on File Yes O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPAC )THIS IS UR PERMIT
Comment: Approve
'OUNOS PRTG.~Blair, NE pnv d/AA
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit. ~ ~ ~
Application Date:__ ` V ~ "~ _ ~~
Permit Fee: $ /~~r
JOB ADDRESSI
LEGAL
1 • DescR. LOT N0. ~ eL TRACT
O SEE ATTACHED SHEET
2. OWNER ~ (~ MAIL AD SS ZIP ~ PHONE
3• CON TOR ~ `.~/ ~/C/ MAILADDRESS PHONE LICENSE NO.
4• Class of Work: EW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE
5• Describe Work:
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
101-200 Amp Fee ............................ $ 18.00 Upgrade Existing Service ......$10.00
Temporary Service ................ $10.00
_ ~~~~
201-300 Amp Fee ............................ $ 30.00 Fire Alarm System ................. $10.00
301-400 Amp Fee ............................ $ 42.00
Signs .....................................$15.00
401-500 Amp Fee ............................ $ 55.00
501-600 Amp Fee $ 67.00
............................ Miscellaneous Apparatus ...... $11.00
601-700 Amp Fee ............................ $ 80.00 AC/DC Circuit ........................ $5.00
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 Amp Fee ....................... $117.00
Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total
New Re
ide
ti
l
Fi
i
h
d A
s
n
a
: (
n
s
e
rea)
NOTICE
I hereby certify that I have read and examined this Singl wo Family Dwellings
V
ft
~~ ~ ~~
. x .045
sq. - -
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of Modular/Manufactured Homes ....... $30.00
work will be com
li
d
ith
h
th
ifi
d h
i
t
p
e
w
w
e
er spec
e
ere
n or no
.
The granting of a permit does not presume to give authority Receptacle/Switch Outlets
to violate or cancel the provisions of any other state or local Fixtures x $.75
law regulating construction or the performance of Smoke Detectors x $3.00
construction.
Residential/Commercial Appliance
# Fixed Outlets x $3.00
Motor(s) x $3.00
Power Apparatus (220 Volts)
SIGNATURE OF CONTRACTOR OR AUTH ZED AGENT # Apparatus x $3.00
~'~ '~ C~ °~ Permit Issuance Fee ............. $15.00 ~ r
DATE
TOTAL
C~ ~
WHEN PROPERLY VALIDATED (IN THIS PACE) THIS IS YOUR PERMIT
Comment: Ap gy;
7~~
POUNDS PRTG: Blair, NE qev. eia7
PLUMING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: l ~ 7 !~
~~o
Permit Fee: $
JOB ADDRESS ~ /
(~
~ MAIL ADDRESS
1 . OWNER
~2-C1~ ZIP PHONE
2 CONT CT R MA ADDRESS PHONE LICENSE NO.
3. Class of Work: O COMMERCIAL ESIDENTIAL NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4• Describe Work:
~ ~~ ~~
~
~~ ~
~ f~~
Comments: PLUMBING PERMIT FEES
Modular Home ...................... $15.00
Type of Fixture No.
Kitchen .................................. $8.00 x
Bath ....................................... $8.00 x
Rough-In Bath ....................... $4.00 x
Slop SinWLaundry Tray ......... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Drinking Fountain .................. $3.00 x
f~
Water Service ........$10.00
................. i
Sewer .................................... $10.00
~~ ~ ~
NOTICE
I 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. Lawn Sprinkler System ......... $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local Sprinkler System ................... $30.00
law regulating construction or the performance of (Commercial)
construction.
Gas/Water Piping System
(Commercial) ............................ $30.00
/~ p G
l
~ Permit Issuance Fee ............. $15.00
GNATURE OF CONTRACTOR AUTHORIZE AGENT ~~ ~ G
TOTAL
DATE Current License on File Yes O No O NA
WHEN PROPERLY VALIDATED (IN THIS SP
Comment:
Approved
IS IS YOUR PERMIT
P 0136
POUNDS PRTG: Blair. NE Rev. 4/98
~a
~®/e - - ~ Q
~~~. ~ ~t,~ ~ ~J
~~ ~
O
~ promise
City of Blair
218 South 16th
Blair, Nebraska 68008
402-426-4191
Fax - 402-426-4195
BUILBING 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: I) 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.
Contractor/Owner
Date
~~~C'~c.,t,csz~'
Contractor/Own
'~tiL~ ~ Ctiv ,
Li
City of Blair
EQUAL HOUSING
OPPORTUNfTY
ClTI(OF RLAIR, NESR~ISi~A
Vendor Number
Claim ®ate
Voucher Number
Check Number
~rrnnnt Rlumh~r
Desrrintinn
v~~ ~9 ~ ~ ^ J J\~ ~J f /1 i
~ ~~r~ / ~/~ / ~~Ct~~~,~ ~ f~-i .G J.-~ ~~,i'
,!?C =~J ~J
t
~ ~ L
Total ~ ~~~ ~~'1
1 d®seleannly swear chat tha above account is trace and correct to the best of my knowledge.
Subscribed and sworn t®befere me this day of
City Clerk
Finance Cao~nanittee AppravaL
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--- ------_ -- .._._...__..__...--...._...---- ---'-------:u -_ -_.. __ ------ ~' ...- ~ --_.. ~ ~ ...__ r-'
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° ~~ BUILDING INSPECTION REPORT ~~'°`'"`~ "~~~-~/G/~
o ~~
~~ CTI'Y OF BLAIR `-` ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION:. ~~ ~~ (/1 ~ ~ ~'~'r~
NAME OF OWNER: /,vr~ ~ E ~`S `~ ~~ ~ ~ ~~~i(-~j'~ ~~
{'` / CONTRACTOR: ,c /J ~' ~ S ~/,a
DATE INSPECTION REQUESTED: `''/ ~~~ ~ TIME INSPECTION REQUESTED: '/ _ - PERMIT N0: ~~-~
s~ ~~ ~ s~~
TYPE OF INSPECTION REQUESTED: ^ CONF RENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL:
~.: _~ ROUGH IN ^ FIXTURES ^ INAL ^ MOTORS ^ PERMANENT SERVICE ^ TEMPORARY SERVICE PASS FAILED
^ PARTIAL ~-S~r~T-- ^
COMMENTS:
MECHANICAL: ROUGH-IN ^ A/C ^ FURNACE ^ FINAL ^ PARTIAL PASSED FAIL
COMMENTS:
PLUMBING: ^ GROUNDWORK ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED .FAIL
^ ~~
COMMENTS:
^ OCCUPANCY GR~ ED ^ CONDITIONAL OCCU NC GRANTED
NOT MARKS. ~/~~~ ~ ~ ~ ~"~
-~~~ ~ ~ .~
FAXED OPPD\
~~ ., d ~, O
•{z ~_ `~
E OF INSPECTfE3N'MADE: TIME:
rs' -i
TO CONNECT SERVICE: ^ YES "^ ~ NO
o BUILDING INSPECTION REPORT
~ CITY OF BLAIR f ^ W//ASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION: / ~~~ CCU z°.~ ~~ ~~/~
/'
NAME OF OWNER: / .Lr~ ~ ~f,~" CONTRACTOR:s )~~=~ ~/~ r" _
. DATE INSPECTION REQUESTED: rY ~ ~ ' ~l TIME INSPECTION REQUESTED: ' ~7 s ~ PERMTI' N0: ~~~ ~~
TYPE OF INSPECTION REQUESTED: ~^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ FRAMING -DRYWALL ^ FINAL ^ PARTIAL P SSED FAILED
^
COMMENTS:
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL: ^ ROUGH IN ^ FIXTURES ^ FINAL ^ MOTORS ^ PERMANENT SERVICE ^ TEMPORARY SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE , ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
PLUMBING: ^ GROUNDWORK ^ .ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY`GRANTED
NOTES/REMARKS:
DATE OF INSPECTION MADE: ~Q ~ TIME:~~ ~~~
FAXED OPPDI TO CONNECT SERVICE: ^ YES ^ NO
- g- o ~ -
CITY OF BLAIR _
BUILDING INSPECTION REPORT ~!°«~~-- ~~'~
^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION:
~ ~ l0 l.Fi ~' ~ ~9 rC/~ .
~
~~)) ~ ~
~
CONTRACTOR; ~~~--1~[i {J¢,~~
NAME OF OWNER: .~~'~~ ~ `G~
~~
DATE INSPECTION REQUESTED: ~~ ~ ~ ~ TIME INSPECTION RE
UESTED
C~ ~ ~c ' ~ ~
'
~
~ ~
Q
:
PERMPI
N0: ~ ~t
^
.~.,_ - _
~
TYPE OF INSPECTION REQUESTED:
^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASSED FAILED
Jr~y( ^
COMMENTS:
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ -WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL: ^ ROUGH IN ^ FIXTURES FINAL ^ MOTORS ^ PERMANENT SERVICE ^ TEMPORARY SERVICE PASS FAILED
^ PARTIAL ^
COMMENTS: -'~
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE FINAL~• ^~PARTIAL ~
~, ~ PAS~AILED
~ ^
COMMENTS:
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN
COMMENTS:
~INAL _ .'~ WATER METER INSTALLED ^ PARTIAL PASSE~y FAILED
,, /rrJ~ ^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
c.
DATE OF INSPECTION MADE:. TIME: ~ L- L/
FAXED OPPD\ TO CONNECT SERVICE: ^ YES ^ NO