BPM0795City of Blair Building Permit Detail
Permit #: M0795 Issued: 6/3/2002 Type: Mechanical Miscellaneous
Completed: 6/12/2002 Valuation:
Location: 822 N. 22nd Street
Owner: Johansen Manor Permit Fee: 10
Address: 822 N. 22nd Street Issue Fee: 15
Deposit Amt.:
Blair, NE 68008 Receipt #:
Phone:
Section: Township:
Subdivision:
A/C and furnace unit replace in Apt 2H
Contractors
Kermeen
Remarks
Range:
Lot:
General Contractor
Block:
Permit # Issued
Inspections Date By
6/12/2002 DEM Final Inspection of Project Pass
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 O 7
Fax (402) 426-4195 M
(402) 426-4191
Application Date:
~UC)
Permit Fee: $
JOB ADDRESS ~~
N
DINER ~ MAIL ADDRESS
1. - ~. ~ r ZIP PHONE
,Z CONT ACTOR MAIL ADDRESS
~~ ~' -C~ 1`l ~ PHONE LICENSE NO.
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3• Class of Work: COMMERCIAL O RESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR REPLACEMENT
4• Describe Work: ~ ,~ r _ ~rl .~ ~ ~
~ MECHANICAL PERMIT FEES
Central A/C
Tons
Furnace BTU/H Forced Air/Heat Pump Systems -Per Unit
Commercial/Residential (New) ................................................... . $25.00
# of Units A/C
Air-Conditioner Unit -Per Unit
Furnace Commercial/Residential (New) ................................................... . $10.00
Forced Air Systems/Air Conditioner ~ ~ ~~~~
O~
l
ti
D
t
C Unit Replacement Per Unit Commercial/Residential .................. . $10.00
omp
e
on
a
e:
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
~ hereby certify that I have rated -~~~ ----„w,:.>od this
a
lication and kno
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c _ _ _ _ __ __.____ ___ _
pp
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ame
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rue an
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t. all
provisions of laws and ordinances governing this type of Modular Home
$15
00
work will be complied with whether specified herein or not. .........................................
.
The
rantin
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ermit does not
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i
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it
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p
p
sume
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ve au
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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 ~ ~• b~
construction
.
TOTAL ~~~, Ck~
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SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
Current License on File O Yes O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By: ~ ~~ i
POUNDS PRTG: Blair, NE Rev. 4/98
^ CTI'Y OF BLAIR
LOCATION OF INSPECTION:
NAME OF OWNER:
$UILDING INSPECTION REPORT
^ WASHINGTON COUNTY,: ^ OTHER
CONTRACTOR: ~~~~ y~--~ h `~ ~ 3 ~ ~ l ~ `1
DATE INSPECTION REQUESTED: ~ ~ ~ ~~ ~ V a TIME INSPECTION REQUESTED: ~_ IYL~ PERMTI' N0: ~ ~ ~'
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 PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED FAILED
-= ^ PARTIAL ^ ^
COMMENTS:
MECHANICAL: ^ ROUGH-IN [~A/C FURNACE ^ RADIANT HEAT ^ INAL ^ PARTIAL
r" PASSE FAILED
COMMENTS: ~ ~ ~' ,-~ t~ ~ ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
~ ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NQTES/REMARKS:
INSPECTOR:
FAXED OPPDIBURT REA
'DATE OF INSPECTION MADE: C/
TO CONNECT SERVICE: ON
r
BY