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P0987City of Blair Building Permit Detail Permit #: P0987 Issued: 10/2/2003 Type: Plumbing Miscellaneous Completed: 10/3/2003 Valuation: Location: 1911 Grant Street Owner: Katy Petersen Permit Fee: 10 Address: 1911 Grant Street Issue Fee: 15 Deposit Amt.: Blair, NE 68008 Receipt #: Phone: Section: Township: Subdivision: Replace Water Service Contractors Henton Trenching, Inc. Remarks Range: Lot: General Contractor Block: Permit # Issued Inspections Date By 10/3/20D3 DEM Final Inspection of Project Pass 10/3/2003 DEM Water Service Pass S~. ~ " PLUMBING PERMIT APPLI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 Application Date: I `' ~ l ~~ CATION P 0987 ~~ Permit Fee: $ JOB ADDRESS OWN MAIL ADDRESS ZIP PHONE C NTRACTOR X MAIL ADDRESS PHONE 2. 1~1..~Y~ i.~ Lf /I I Yl ~ L-~'7 ~~, Li:~r.-(w'~ 3 0 i~ i_Ct. t f' LICENSE NO. ``~c•~ ~~, .__ Cj ~~:~ 3• Class of Work: O COMMERCIAL SIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR I~REPLACEMENT 4• Describe Work: G~- ~~ U ~~ ~ Comments: PLUMBING PERMIT FEES Modular Home ...................... $15.00 Type of Fixture No. Kitchen .................................. $8.00 x Bath ....................................... $8.00 x Rough-In Bath ....................... $4.00 x Slop Sink/Laundry Tray ......... $5.00 x Water Heater ......................... $3.00 x Outside Water Faucet ........... $3.00 x Drinking Fountain .................. $3.00 x Water Service $10.00 I ~ ~ • ~-~~~ NOTICE Sewer .................................... $10.00 I hereby certify that I have read and examined this Groundwork ........................... $10.00 application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Septic Tank & Laterals .......... $10.00 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority Lawn Sprinkler System ......... $10.00 to violate or cancel the provisions of any other state or local Sprinkler System ................... $30.00 law regulating construction or the performance of (Commercial) construction. Gas/Water Piping System / (Commercial) ............................ $30.00 ~- ~ ~ _ ~ ~ Permit Issuance Fee ............. $15.00 . ~ C. ~ ~--°' U SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ~ ~~~ TOTAL ~ ~ DATE Current License on File ~es O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: ~ ~ ~-~~~ POUNDS PRTG: Blair, NE Rev. 4/BS BUILDING INSPECTION REPORT ~; ,, ,~ ^ CITE OF BLAIRy ^ WASHINGTON COUNTY ^ OTHER ^^ LOCATION OF INSPECTfON: _ ~~ (~ ~ ~ Il.f' c~ T NAME OF OWNER - T ~ -~ ~ ~ ~ ~~ lI ` ~ ~ + ~' ~Y ~' ~ Y ~^~. :. 1~T .CONTRACTOR: ~ ~ W DATE INSPECTION REQUESTED: 3 TIME INSPECTION REQUESTED PERMIT NO: ~ CJ~I " ~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECKFOOTING ^ FRAMIIVG ^ DRYWALL ^ FINAL ^ PARTIAL PASSED.- FAILED ^ COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC . ^ WATER TAP ^ REMOTE ATER SERVICE ~ PASSED FAILED ` ' ^ PARTIAL .COMMENTS: ,~ 1~Q~ ~ ~ ~~ ~ ~~ ~ ^ 'E~:ECTRICAL: ^ 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: FAXED OPPD~BURT REA TO CONNECT SERVICE: ON