BPM0844City of Blair Building Permit Detail
Permit #: Mp844 Issued: 9/27/2002
Completed: 9/30/2002
Location: 830 N. 26th Avenue
Owner: Larry Dornacker
Address: 830 N. 26th Avenue
Blair, NE 88008
Phone: 4024 533 2796
Section: Township: Range:
Subdivision: Lot:
90,p00 B7U Furnace replacement and 3 ton A/C
Contractors
Kermeen
General Contractor
Remarks
Type: Mechanical Miscellaneous
Valuation:
Permit Fee: 20
Issue Fee: 15
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
9/30/2002 DEM Final Inspection of Project Pass
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M ~ $ '~ '~'
(402) 426-4191
Application Date: ~I Z 7 (d 2
Permit Fee: $ 3 s ' ~~~
JOB ADDRESS ~ ~ ~ ~ ~ ~. L[ n ~~
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1 OWNER
MAILA
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RESS ZIP PHONE
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2 CONTRACT MAIL ADDRESS PHONE LICENSE NO.
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3• Class of Work: O COMMERCIAL RESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4• Describe Work: ~Lt.i?.l'1/~.(.C,2 ~~ ~~G ~ ~C~_6~1~
Central A/C ~ Tons MECHANICAL PERMIT FEES
Furnace ~(J ~n ~ 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
Unit Replacement Per Unit Commercial/Residential
$10
00
Completion Date: ...................
.
Refrigeration Units/Coolers/Lines/Compressor -
Per Unit Commercial (New or Replacement) ...... ..................... $10.00
Comments:
Appliance Vent/Fans ...............................$10.00
Boiler .......................................................$15.00
Duct System ............................................ $10.00
Gas/Air Outlets .................. x $2.00
NOTICE Radiant Heat Systems ............................$25.00
I hereby certify that I have read and examined this
a
lication
nd k
th
t
b
pp
a
now
e same
o
e true and 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
rantin
of a
ermit d
t
t
i
g
g
p
oes no
presume
o g
ve authority
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 ~ S . C5(~
--
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
Current License on File t~Yes O No O NA
DATE /
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG: Blair, NE Rev. 4/98
BUILDING INSPECTION REPORT
~CTI'Y OF BLAIR
/LOCATION OF INSPECTION: ^ WASHINGTON COUNTY ^ OTHER
~ ~ d ` `~ ~ ~~~ ~ ~- ~~ <<~~-
NAME OF OWNER: ~ ~ ~ ~ ~
DATE INSPECTION REQUESTED ~"'`I ~ n ~~ ~~~ ~ CONTRACTOR: l~~ r m ~Q !mil
: ~ 3 ~~/ 6 ~ TIME INSPECTION REQUESTED: / ' ~ ~ PERMIT N0: ' ~ ~7
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE
^ PARTIAL
COMMENTS: PASSED
^ FAILED
^
ELECTRICAL: ^ ROUGH IN
^ PARTIAL
COMMENTS: ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE . ^ PRECONNECT PASSED
^ FAILED
^
MECHANICAL:
~ I9 A/C ~ E ^ RADIANT HEAT ~ FINAL ^ PARTIAL PASSED FAILED
/
r
COMMENTS: ^ ^
PLUMBING: ^ GROUNDW ORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
DATE OF INSPECTION MADE: ~ ~ TIME: ~~ ~~`°
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY