P0905City of Blair Building Permit Detail
Permit #: P0905 Issued: 5/5/2003
Completed: 5/5/2003
Location: 269 N. 20th Street
Owner: Russ Penke
Address: 269 N. 20th Street
Blair, NE 68008
Phone: 402 426 5104
Section: Township:
Subdivision:
Replace sewer line and water line
Contractors
Henton Trenching, Inc.
Remarks
Type: Plumbing Miscellaneous
Valuation:
Range:
Lot:
General Contractor
Permit Fee: 20
Issue Fee: 15
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
5/5/2003 DEM Sewer Lines Pass
PLUMBING PERMIT APPLI
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
. ~I~,~~
Appllcatlon Date.
CATION ~
P 0905
~ermlt Fee:
JOB ADDRESS
1 . O~FlR ~~ ~ ~ MAI~DDRE S_ ~ ~ ~ ZIP
S PHO E O, r
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2. RACT R
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~ ` MAIL ADDRES
PHONE LICENSE NO.
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3• Class of Work: O COMMERCIAL ESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR EPLACEMENT
4• Describe Work: ~ rSL
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 SinklLaundry Tray ......... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Drinking Fountain .................. $3.00 x
Water Service ........................ $10.00 ~ / ®• UCH
Sewer .................................... $10.00 ~ ~ ~ ' ~
NOTICE -
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 other state or local Sprinkler System ................... $30.00
law regulating construction or the performance of (Commercial)
construction.
Gas/Water Piping System
mercial) ............................ $30.00
+ ~ `~
Permit Issuance Fee ............. $15.00
SIGNATURE OF CONT CTOR OR AUTHORIZED AGENT
TOTAL
~~~
DATE Current License on File files O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPAC
Comment:
Approved By:
IS IS YOUR PERMIT
POUNDS PRTG.~Blair, NE Rev. M99
BUILDING INSPECTION REPORT
CITY OF BLAIR
LOCATION OF INSPECTION:
NAME OF 0 WNER: ~ ~~
CONTRACTOR: ~ ~"'~
DATE INSPECTION REQUESTED: ~~ ~ ~~ TIME INSPECTION REQUESTED: ~'" '
PERMIT NO: ~ ~ ~ 0
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT RASSED 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 GRA/N~TED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS: ~ T"~'~°-~~ ~-t~PJ'I-~~ ~~_~ ~- ^~r y1~P~.~ ~.t~~
INSPECTO _ - DATE OF INSPECTION MADE:. ~ TIME: i ~, `~~~`'
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
^ WASHINGTON COUNTY ^ OTHER
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