BP9758The City of Blair Building Permit Detail
Permit #: 9758 Issued: 05/13/2002 Type: Patio -Screened Porches
Completed: 06/27/2002 Valuation: 1000
Location: 2155 Park St.
Owner: Valerie M. Jensen Permit Fee: 15
Address: 2155 Park St. Issue Fee: 15
Deposit Amt.:
91air, NE 68008 Receipt #:
Phone: 426-9092
Section: Township: Range:
Subdivision: Lot: Block:
Tear off existing porch & replace w/ new porch, windows w/ porch door, no electricity, 5'6 x 18'
Contractors
SELF General Contractor Permit # Issued
Remarks
Inspections Date By
06/27/2002 DEM Final Inspection of Project Pass
~~
BUILDING PERMIT APPLICATION
l~^ 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
Deposit Receipt #:
Issue Date: ~ ~,~ C~ ~ Type: ~
JOB ADDRESS
'- '' /
,/
LEGAL
1 . DESCR.
J
^ SEE ATTACHED SHEET
OWNER -
2, f , MAIL AD RESS
/~ Zlp HOME PHONE
WORKICELL PHONE '~
CONT R
3. MAIL ADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class o Work: ^ NEW Q ADDITION REMODEL ^ OTHER ^ FINISHED BASEMENT O UNFINISHED BASEMENT
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5. Describe Work: ?
~
@~
~ ~ 7 ~-
~r ' ~ b
A `~ ~~~
6. Valuation of Work: $ QQ(~ Total Sq. Footage (IRCludingBasemencandGarage): Total Finished Area:
Floodway Q Yes Q No
7. Floodplain: Fringe ^ Yes Q No Dev. Permit
BFE
Elev. Cert.
8. Current Zoning: !"~i~~1 ~-
9. State Fire Marshall Required: Q Yes ~ No
10. Special Use Permit Required: Q Yes ~1Vo
11. Variance Required: Q Yes ~o
12. Minimum Setbacks: Front . 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 signature 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 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. I understand thatthis permit is void if work is not commenced within
180 days or i~.no ompleted within j2 years of date of issue.
SIGNATURE 0 OWNER/CONTRACTOR DATE
Comment:
Q Site Plan Attached ~ ~~ Co~'npJ_et~ans Attached
Approximate Completion Date _~ / ((~~
Inspections Required and Fees
Utilitie
Sewer Water Service
Septic Remote
Stop Box Card
Building
Footings Drywall
(PRIOR TO TAPING)
Framing Final
Electrical
Rough-in
Final
Temporary Service
Mechanical
Rough-in _
Final
PI mbin _
Ground Work
Rough-in _
Final
I WHEN PROPERLY VALIDATED (IN THIS~PACE) THIS IS YOUR PERMIT
Approved By: ~~ , /
Permit
9758
Fixtures
Permanent Service
A\C
POUNDS PRTG.-Blair, NE ~ Rev. 6/96
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promise
city ~>fBlCllY
BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet includes various items dealing with particular code
requirements andfor 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 ownerfcontractorfnr this project.
~~
OwnerfOccupant J Contractor
City of Blair Date
218 S.16TH STREET, BLAIR, NE 68008.2010 • (402) 426-4191 • (402) 426-4195 FAX • E-MAIL: cityofblair@huntel.net ~,uN~
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BUILDING INSPECTION REPORT
^ CITY OF BLAIR ^ WASHINGT/~ON COUNTY Q ^ OTHER
LOCATION OF INSPECTIOI/N: / /~~
NAME OF OWNER: r ~~~ `-'~ ~~ ~~"' \ CONTRACTOR:
(~ -7 ~C / ~/ ~
DATE INSPECTION REQUESTED: % L (/y z TIME INSPECTION REQUESTED: ~r PERMIT N0:
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASSED AILED
/~~~~~ l ^
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 ^ 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: ~ /~ L ! TIME: f "° `, /~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
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