BP12696
Blair Building Permit Detail
Permit #: 12696 Issued:
Completed:
Location: 237 Wetlands Rd
Owner: Jason Berg
Address: 237 Wetlands Rd.
4/13/2007
5/22/2008
Type: Industrial/Commercial - New Const.
Valuation: 400000
Blair, NE 68008
Phone: 719 8296
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
1640
20
500
19297
Section:
Township:
Range:
Lot: 2
Block:
Subdivision: ERIKSEN
Building used for storage of equipment fOJ River City Round-up. See permit #11821 - this permit replaces that one.
Contractors
Stirek Construction Services, Inc.
~ick's Electric
General Contractor
Electrical Subcontractor
Permit #
E2683
Issued
6/14/2007
Remarks
5/24/2007
OEM
Not complete.
6/15/2007
OEM
Gate locked. Called Brent, but he was out of town
6/19/2007
OEM
No access allowed.
11/26/2007 OEM OPPO has not run power to the building yet.
Inspections Date By
4/23/2007 OEM Footings Pass
5/24/2007 OEM Status check Fail
6/15/2007 OEM Final Inspection of Project Fail
6/15/2007 OEM Electrical Final Fail
6/19/2007 OEM Electrical Permanent Service Fail
9/4/2007 OEM Electrical Permanent Service Pass
11/26/2007 OEM Final Inspection of Project Fail
11/26/2007 OEM Electrical Permanent Service Pass
5/22/2008 OEM Electrical Final Pass
5/22/2008 OEM Final Inspection of Project Pass
Date: 'f~~ 10,
Site Plan Attached: --X.. REScheck Attached:
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # /:< f.tJ q /.1
Approximate Completion Date: if - ( 3..; () 8
Complete Plans Attached
Aoolication for: Residential Commercial/Industrial
New Construction X Manufactured Home Modular
Move-on: Home Accessory Building Other
Remodel Addition
Accessory Building: Garage _
Floor Type: Dirt )(
Other
)(
Pole Barn_ Other
Concrete Electricity: Yes ~ No
Utilities: Public Water: Yes No X Private Well
If yes, responsible entity: Blair _ OPPD Line _ Kennard _
Agreement needed: _ Date Agreement Received: _
Public Sewer: Yes_ No ,')( Septic Drawing Provided: _
If yes, responsible entity: Blair _ Kennard_
County Road Permit Required: Yes_ No _ Submitted: Yes _ No _
of
Proiect Information:
Job Address:
2.3"1
''We-+ lOAd s 'KoQd
Lo+ 2 t=1'" ( f~sel\
I
Su Wi 01 ':S((J~
Phone#:11 '1- ~ Z. 9k,
Phone #: Lf 21003 2-y
C 72-0'L'K
Cell #:
Legal Description (if applicable)
Owner: :\,as,df'\~.e rj Address: (~~dc J?- p.sO
Contractor: ~\ (r> K (:c){'LSU u CA,-l~
Address: D(j l2?6x to 's tal r
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic systems. By my signature
below, I acknowledge this building permit application 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 a permit 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
codesjordinan es of the City of Blair and the State of Nebraska. I understand that this permit is void if work is not commenced within
:3/J'''' I 00' oompl... I " '~= ~'te of I~",. .J..j _ ) 3 _ D I
ignature of Owner/Contractor Date
ZONING REVIEW:
Conditional Use Permit Required: Yes _ No ~
Date CUP ,Approved:
State Fire Marshal Required: Yes _ No ~ Variance Required: Yes _ No--,-
Minimum Setbacks: Front .;;zC::;- Second Front Side . S- Side _ Rear-LJ.....
\ ND 0 LCU--pCU\~ l).a~J
Lot Sauare Footage:
Length x Width:
Lot Coverage %
Driveways/Sidewalks:
Sidewalk required: Yes_ No * Sidewalk Waiver: Yes No
. Date Waiver Approved:
Flood Plain: Yes No '-L
If yes, specify special r~ents:
BUILDING INSPECTOR REVIEW:
Number of Stories
One -+- Two _ Three
Four
>Four
High Rise (>75ft)_
Type of Residential Structure:
Ranch _ Two Story _ Split Entry _ Raised Ranch _ Other
Rooms _ Bedrooms _ Bathrooms _ Fireplaces _ Gas_ Electric _
Egress in Basement: Required: Yes _ No _ Provided on Plans: Yes No
Sleeping Rooms Living Area Other Egress
Square Foota~e:y (
Main Level: ~O ~ l(do',~ (1(,1ftlo
Basement: (Unfinished)
Garage:
Detached Garage:
Addition:
Porch: Front Rear
Deck that affect setbacks: Rear
Second Level: Third Level
(Finished)
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front Side
Occupancy Classification:
Assembly, theaters, with stage Assembly, theater, without stage _
Assembly, nightclubs _ Assembly, restaurants, bars, banquet halls _
Assembly, churches _ Assembly, arenas _
Assembly, general, community halls, libraries, museums _
Business Educational Factory and industrial, moderate hazard _
Factory and industrial, low hazard _ High Hazard, explosives _
High Hazard HPM Institutional, supervised environment_
Institutional, incapacitated _ Institutional, restrained _
Institutional, day care facilities _ Mercantile _ Residential, hotels _
~(i cuJ~- NO l\W-\f'oJ\Uy S/fJrt!jc Dnj
Residential, multiple family _ Residential, one- and two-family
Residential, care/assisted living facilities
~q~ 'Otuk~
Storage, i"tro ~!; r ~Storage, low hazard _ Utility, miscellaneous_
Driveway Grade: (percentage) (Dale will review new residential construction) (AI
will review all second access requests and industrial and commercial driveway requests)
Required Off Street Parking:
Permit Fee Calculation:
RESIDENTIAL - NEW CONSTRUCTION:
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
All other permits valued under $10,000 No Deposit Fee
Perm it fee is:
Finished sqjft area
(not including finished basement area)
Finished basement sqjft area
Unfinished basement sqjft area
Garage sqjft area
Total Valuation:
X $88
$
$
$
$
$
$
$
$
X $53
X$26
X $20
Total Valuation
Multiplied by 0.0056 =
Issuance Fee:
20.00
Total Permit Fee = DepositjPermit Fee/Issuance Fee
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Business/I ndustrialjEd ucationalj Assem bly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $ 5/)0,00
Fee.. $500.00
All other permits valued under $10,000 No Deposit Fee
Permit fee is:
Finished sqjft area
Finished sqjft area
~~
10,000
X$60
X $40
$
$ if'OOJtJOD
$0 TO $49 ..............................................................................................$0 (plus Permit Issuance Fee)
$50 TO $9,999 ........................................................................................... $50
$10,000 TO $99,999........................................................................................... $50 + $6 per additional $1,000
$100,000 TO $249,999 .........................................................................................$590 + $4 per additional $1,000
$250,000 TO $499,999..................................................................................... $1,190 + $3 per additional $1,000
$500,000 TO $999,999 ..................................................................................... $1,940 + $2 per additional $1,000
$1,000,000 AND OVER ..................................................................................... $2,940 + $1 per additional $1,000
$ ,) I.P Lj-O. 00
Permit Fee calculated from chart above
Issuance Fee:
$ 20.00:: II (p 1.P O. 00
$ "tic5( I Il.o O. 0 ()
Total Permit Fee = DepositjPermit Fee/Issuance Fee
Additional Comments:
Approved by: /)~~ate: ~~6~ '7
Contingent On Approval by Fire Marshall V-
Meet IBC, IPC, IMC and NEC Code Requirements ~
Sleeping Rooms below Story and in Basement required to have egress
For Office Use Only
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Date Permit Paid: if.~ ;Ju ~() I
Permit Fee: I LP Lv 0, () ,)
Deposit Amount 5i)(). 00
Receipt # /q ~ '17
Deposit Paid by for return to:
Building Inspection Pouch given: Yes~ No
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ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:
Job Address
Owner
1.
Permit Fee: $
. :J tVJ1 cW
/. Zip
dlOCll1L
b8;
E 2683
3!#. '-16
Phone
~~ntrac l~f::U (v
3. Class of Work: 0 NEW RESIDENTIAL 0
Describe Work: .
4. I t'JO ~. Jl'JU 1/.,,/ lj
5.Current License on File ..'S(Yes 0 No 0 N/A
.c(.JCJ
P t:f, J]tJy;
NEW COMMERCIAL 0 REMODELING/ADDITIONS 0 UPGRADE SERVICE
cJ? c? P /-Jb ~ S O*l d d vYM/'~alz.iZd.:J
Service Fee = (Amp Fee + 2.00 per branch circuit)
1-100 Amp Fee..................... ..$13.00
101-200 Amp Fee..................... ..$18.00
201-300 Amp Fee... ... ... ......... .....$30.00
301-400 Amp Fee... ... ... ... ... ... .....$42.00
401-500 Amp Fee.................. .....$55.00
501-600 Amp Fee...... ...... ... ..... ...$67.00
601-700 Amp Fee...... ...... ... ..... ...$80.00
701-800 Amp Fee...... ... ... ... ...... ..$92.00
801-900 Amp Fee................... ..$105.00
901-1000 Amp.. . .. . .. . . .. .. . .. . .. . .. . $11 7 . 00
IF OVER 1000 Amp
1 st 1000 Amp Fee.............. ....$117.00
Each additional 100 Amps..... ....$13.00
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. AIl
provisions oflaws and ordinances governing this type of
work will be complied with whether specified herein or
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
I)-I f-{)'~
Date
t:U4 ;;8titJ8
Phone
Completion Date
ELECTRICAL PERMIT FEES
Upgrade Existing Service............ .$10.00
Temporary Service.................... $10.00
Fire Alarm System... .............. ....$10.00
Signs................................ ......$15.00
Miscellaneous Apparatus......... .....$11.00
AC/DC Circuit....................... ....$5.00
CommerciallMulti Family and All Upgrades:
# of Circuits x $2.00
Amp Fee ~ 3.00
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x .045
Modular/Manufactured Homes... ...$50.00
Receptacle/Switch Outlets
Fixtures c.l:) x $.75
Smoke Detectors x $3.00
Residential/Commercial Appliance
# Fixed Outlets x $3.00
Motor(s) x $3.00
Power Apparatus (220 Volts)
# Apparatus x $5.00
Permit Issuance Fee.................. ..$20.00
Comment:
13 .00
3,75
Total
:;;1).00
. .15
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: ;is f?~1 ~YI
~
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BUILDING INSPECTION REPORT
o c;ITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION' / ~:;"\~' :':;' ''/
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NAME OF OWNER'
CONTRACTOR'
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DATE INSPECTION REQUESTED' <'." .,/ ,-"C '1' / eyl;!; TIME INSPECTION REQUESTED'
/ i
/~~\f/') -/
PERMIT
TYPE OF INSPECTION
o CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED FAILED
0 0
COMMENTS:
UTILITIES: 0 SEWERTAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATERSERVICE
o PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
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NOTES/REMARKS' /t)// it:/ /;;~l:
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TIMF'c:7. I/O
FAXED OPPD\BURT REA
TO CONNECT SERVICE:
BY
a:LAill
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
NAME OF
DATE INSPECTION REQUESTED' ,./(/
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/',.(" t;r"
TIME INSPECTION REQUESTED'
/l.l~ -"-;7
LOCATION OF
TYPE OF INSPECTION
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0
o CONFERENCE
o PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
D 0
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FAXEDOPBD\BURT REA TO CONNECT SERVICE:
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BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
LOCATION OF
it ;' l }
CONTRACTOR' \ ;' ,.l.ff:t:..-
NAME OF
DATE INSPECTION REQUESTED' I'
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TIME INSPECTION REQUESTED' ,/ t, j ,
PERMIT
TYPE OF INSPECTION
o CONFERENCE
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
o STATUS CHECK
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED
0
PASSED FAILED
0 0
PASSED FAILED
0 0
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH fN 0
o PARTIAL
PRECONNECT
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
At ;l(!(e~s
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INSPECTOR'
DATE OF INSPECTION MADE: !I'" I q ....0 1
TIME'
FAXED OPPD\BURTREA
TO CONNECT SERVICE:
Dcm~
BUILDING INSPECTION REPORT
LOCATION OF
TIME INSPECTION REQUESTED'
PERMIT NO'
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o WASHINGTON COUNTY
NAME OF
DATE INSPECTION REQUESTED'
TYPE OF INSPECTION
o CONFERENCE
o STATUS CHECK
PASSED FAILED
0 0
PASSED FAILED
0 0
PJ1D FAILED
0
PASSED FAILED
0 0/
PASSED FAILED
0 D'.
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0
o PARTIAL
PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
COMMENTS:
MECHANICAL:D ROUGH-IN 0 A/C 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
TIMF.- ,3 ~)
FAXED OPPD\BURT REA
TO CONNECT SERVICE:
[;l~LA1R
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION:
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NAME OF OWNER'
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DATE INSPECTION REQUESTED' { /
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TIME INSPECTION REQUESTED' I'
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL.~b2.;'FrNAL 0 PARTlAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH
o PARTIAL
PASSED FAILED
o 0
SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
P~D FAILED
r 0
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
PASSED FAILED
d 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTO .
.r
FAXJ:j~~J?DWURT REA
TO CONNECT SERVICE:
1 TIMP' // II)
BY p~
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY, STATE. ZIP CODE
THANK YOU
KEEP THIS COpy FOR YOUR RECOROS.
NO
I,.'..'
Pounds Printing, Blair, NE 68008
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
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DATE INSPECTION REQUESTED'
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"(':1",;}(~>)" ,:li::} TIME INSPECTION
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL,~,::;FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWERTAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
FAILED
o
COMMENTS:
ELECTRICAL: 0 ROUGH
o PARTIAL
PASSED FAILED
o 0
o PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
COMMENTS:
MECHANICAL:D ROUGH-IN 0 A/C 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
o 0
NOTES/REMARKS'
IN~
FAXED OPPD\BURTREA
TO CONNECT SERVICE: ON
BY
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. I2J CITYOF BLAIR
BUILDING INSPECTION REPORT
ii'
o WASHINGTON COUNTY
LOCATION OF INSPECTION'
o OTHER
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NAME OF OWNER\. )(C 'Aii l:;(L '( '(l,\,
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TIME INSPECTION REQUESTED' ,,- ..J'"j
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PERMIT NO' !
TYPE OF
BUILDING:
o CONFERENCE
FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES:
SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
PARTIAL
FAILED
o
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
o
FAILED
o
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
o 0
NOTES/REMARKS'
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DATEQF INSPECTION MADE: I
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APPf<Ox. LGJe. (it1YliEWltR 11 Se1:J'3liI'21"W 1327. 87' (M & R
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CITY or BLAIR
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ol'JJise 01 ~\}
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected at the time of your building
permit application for all commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater. However,
the City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) theft of water service by either the plumber, owner or general
contractor,
2) all required inspections have not been obtained,
3) occupancy occurs prior to a final inspection,
4) all permits have not been obtained,
5) the project is completed without a final inspection being done.
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 SHALL be
forfeited or discounted upon the discretion of the' City of Blair, Building and
Inspections Department.
~
RIr. -- >
Contractor/Owner
Contractor/Owner
City of Blair
J;-'-J-3 --0 7
Date
@-
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci.blair,ne, us :::':,','i"~J~:
BUILDING INSPECTION REPORT
o CITY OF BLAIR
LOCA nON
o WASHINGTON COUNTY
NAME OF
DATE INSPECTION
TIME INSPECTION REQUESTED'
PERMIT
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
COMMENTS:
MECHANICAL:D ROUGH-IN 0 A/C 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
o STATUS CHECK
PASSED FAILED
0 0
PASSED FAILED
0 0
p;rD FAILED
0
PASSED FAILED
0 0
PASSED FAILED
0 0
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0
o PARTIAL
PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
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--
.
BUILDING INSPECTION REPORT
~ITY OF BLAIR
D WASHINGTON COUNTY
o OTHER
c/ g 7 v_iLl! a17dLLJ
LOCATION OF INSPECTION'
NAME OF OWNER' cJcILJcJ71 '&'1 fI';>
DATE INSPECTION REQUESTED' 6-'. d C;; - 08
rV_l
/t:: c.,r,
0:' /}
CONTRACTOR' c_\ $?.;.bU'tt.".; (,fn [~/:4L./(?]'!t;'~
TIME INSPECTION REQUESTED' /V,'c3CJAf'I'PERMITNO' /;;2 & q it?
TYPE OF INSPECTION REQUESTED: D CONFERENCE
fJiI I!ll. -
BUILDING: D FOOTING D DECK FOOTING D FRAMING DDRYWALL~AL D PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP 0 REMOTE 0 WATER SERVICE
D PARTIAL
PASSED FAILED
o 0
COMMENTS:
- -wo/'W- ~ ___ m.uan::_
ELECTRICAL: D ROUGH ~rNAL 0 PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
.....~-
--lP F~
PASSED FAILED
o 0
COMMENTS:
MECHANICAL:D ROUGH-IN D A1C 0 FURNACE D RADIANTHEAT D FINAL D PARTIAL
COMMENTS:
PLUMBING:
~...~~~
=lV.l!l!Ji~___..s:...a:...~ --~-
COMMENTS:
D GROUNDWORK 0 ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
o 0
~~~-
-~=m=~
o OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
TE OF INSPECTION MADE:
IN
FAXED OPPD\BURTREA
TOCONNECTSER~CE: ON
BY