BP7636The City of Blair Building Permit Detail
Permit #: 7636 Issued: 4/22/97
Completed: 3/10/99
Owner: Lee Jensen
Address: 1028 South Street
Blair, NE 68008
Phone:
Type: Miscellaneous building permits
Valuation: $1,000.00
Section: Township: Range:
Subdivision: Lot:
Change roof pitch
****permit was lost -not sure if completed
Inspections Date By
Remarks
Permit Fee: $15.00
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Contractors
SELF General Contractor Permit # Issued
BUILDING PERMIT APPLICATION
~ ~.~ ~ Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008
Deposit Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit-
Application Date: ~ • ~~~ ~ Issue Date: ~ ~ r
JOB ADDRESS
LEGAL
1. DESCR. LOT ND. BLK. TRACT
^ SEE ATTACHED SHEET
OY,INER MAILg~ppDRF~ ~ 1 ZIP PHON
2. + rack ~v~hsor 34~b C-'~ - K~, 33 ~G[I r JU~, g ~a~° ~~20 ' ~I~
CONTRAC OR MAIL ADDRESS
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4. Class of Work: O NEW O ADDITION O REMODEL
5. Describe Work: o ~ ~ ~ ~ S ~ -y- O Finished Basement O Unfinished Basement
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6. Total Sq. Footage (Including Basement and Garage): Total Finished Area:
7. Valuation of Work: $ g 3 g , ~ ~
Floodway O Yes O No
8. Floodplain: Fringe O Yes O No Dev. Permit
BFE Elev. Cert.
9. Current Zoning:
10. State Fire Marshall Required: O Yes O No
11. Special Use Permit Required: O Yes O No
12. Variance Required: O Yes O No
13. Minimum Setbacks: Front Side
O Site Plan Attached O Com lete Plans Attached
Approximate Completion Date 3' I ~ ' ~ G
Inspections Required and Fees
Utilities
Sewer
Rear Septic _
14. Sidewalk Required: O Yes O No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septicsystems. Bymysignature 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 by the Building
Inspector.
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 not completed within 2 year of date of issue.
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SIGNATURE OF OW ER/CCNTRACTOR DATE
Comment:
Water Service
Remote
Stop Box Card _
Drywall
(before finish)
Final
Fixtures
Permanent Service
A1C
Final
Buildin
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical _
Rough-in
Final
Plumbin
Ground Work _
Rough-in
WHEN PROPERLY VALIDAT (IN THIS S
Approved By: ~ ~
8287
THIS IS YOUR PERMIT
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POUNDS PRTG: Blair, NE Rev. el96