P0980City of Blair Building Permit Detail
Permit #: P0980 Issued: 09/12/2003
Completed: 09/15/2003
Location: 849 S 16th Street
Owner: Mike Prochaska
Address: 849 S 16th Street
Blair, NE 68008
Phone: 402 533 4467
Section: Township:
Subdivision:
Replace water lines up to the house
Contractors
Henton Trenching, Inc.
Remarks
Type: Plumbing Miscellaneous
Valuation:
Range:
Lot:
General Contractor
Permit Fee: 10
Issue Fee: 15
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
09/15/2003 DEM Final Inspection of Project Pass
09/15!2003 DEM Water Senrice Pass
~S
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 P ~ 9 $ o
(402) 426-4191
Application Date: 1 ~ ~ ~ - U~
dS v
Permit Fee: $
JOB ADDRESS ~~ / Q ~_ / / r'L ~l
( ! •
1. OWNER ~ ~ n
MAIL ADDRESS ~ , ~ ~ G~ A ~ ZIP ~V V V ~ PHONE
2 CO ~TRAC~ MAIL ADDRESS PHONE LICENSE NO.
SL.
3. Class of Work: O COMMERCIAL ESIDENTIAL O NEW O ADDITION O ALTERATION REPAIR O REPLACEMENT
4• Describe Work: R ~~'~ J -~ ~,~~~
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 ~ U- U
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. Lawn Sprinkler System ......... $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any otherstate or local Sprinkler System ................... $30.00
law regulating construction or the performance of (Commercial)
constructign.
.,' Gas/VVater Piping System
J
_
~'
~
(Commercial) ............................
$30.00
~
~~ ~
'' ~~y17
Permit Issuance Fee $15.00
/,' SIG ATURE F CONTRACTOR OR AUTHORIZED AGENT
i-' "-~
TOTAL ~~" V
?;'
~
DATE Current License on File es O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
°OUNDS PRTG: Blair, NE Rev. 4/9S
:BUILDING INSPECTION REPORT
,~
CITY OF BLAIR W GTON COUNTY ^ OTHER
LOCATION OF INSPECTIO ~ ~ 1 ' ~ v
NAMI: OF OWNER: ~~ ! ~~ ;~u~(--~ CONTRACT `~
OR.
2
~(
DATE INSPECTION REQUESTED: ~ ~ ~1 TIME INSPECTION REQUESTED: D ~ ~ ~' - ` PERMIT /`
N0: ~ y
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 WAT . R SERVICE
^ PARTIAL ~ ~e ~~
COMMENTS: PASSE
_ FAILED
^
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT
PARTIAL
COMMENTS: 'PASSED °
^ FAILED
^
MECHANICAL: ^ -ROUGH-IN ^ A!C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED - FAILED
COMMENTS: ~
E ' ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSER 'FAILED -
COMMENTS:
^ OCCUPANCY GRANTED ^: CONDITIONAL OCCUPANCY GRANTED
NOTES/ItEMARKS:
FAXED OPPDIBURT REA
TO CONNECT SERVICE: ON
BY
TIME: ~~°~~