BP9436City of Blair Building Permit Detail
Permit #: 9436 Issued: 11/14/2002 Type: Sheds
Completed: 1/2/2003 Valuation: 600
Location: 435 N. 22nd Street
Owner: Scott Polzin
Address: 435 N. 22nd Street
Blair, NE 68008
Phone: 402 426 5573
Section: Township:
Subdivision:
10 x 14 wood shed on concrete slab
Contractors
SELF
Remarks
Range:
Lot:
General Contractor
Permit Fee: 15
Issue Fee: 15
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
1 /2/2003 DEM Final Inspection of Project Pass
BUILDING PERMIT APPLICATION
_,o~ ~ Jurisdiction of City of Blair, Nebraska
Permit Fee: ,~ 218 South 16th Street
Issuance Fee: 1 ~~ Blair, Nebraska 68008 9 4 3 6
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #:
Issue Date: < < ~ ~ (~2 Type: s~ Yt Q
JOB ADDRESS
LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
OWNE ~
2. ~~ ~ ~ZI n MAIL ADDRESS
~ ,^, `` Zlp
IV 22~~ ~T HOME PHONE
WORK/CELLPHONE ~~ ~~~3
CO~R~CTQF~
`3. (T~ MAIL ADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class of Work: O NEW ~ ADDITION 0 REMODEL INISHED BASEMENT O UNFINISHED BASEMENT
OTH
ER Q F
5. Describe Work: ~-f - ~ ~ rJ ~(, I ~ -i
1
~apCl S ~'l~ G~ O}~1 C~t~1 (~~ ~~`S~Q~
6. Valuation of Work: $~p(~j `~ Total Sq. Footage (IRCluaing Ba6emeRt ana Garage): Total Finished Area:
Floodway Q Yes ~ No
7. FIOOdplaln: Fringe ^ Yes ^ No Dev. Permit
BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes
10. Special Use Permit Required: O Yes
~No
~'No
11. Variance Required: Q Yes o
12. Minimum Setbacks: Front Side ~ Rear
13. Sidewalk Required: 0 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 acknowledgethat 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 des or is not completed within 2 years of date of issue.
OF
%_ /y, ~Z
DATE
Comment:
MEET fBG, I~Cx~~,11VI~ANa'N~GQ~i~QUiR~M~NI~
^ Site Plan Attached f l' ~Q~ o~mplete Plans Attached
Approximate Completion Date I
Inspec ions Required and Fees
Utilities
Sewer Water Service
Septic Remote
Stop Box Card
Building
Footings Drywall
(PRIOR TO TAPING)
Framin
g
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A1C
Final
Plumbing _
Ground Work
Rough-in
Final
WHEN PROPERLY VALI ATE (IN THIS
Approved ,j
R PERMIT
Rev. 6/96
POUNDS PRIG: Blair, NE
~~ • u~ BUILDING INSPECTION REPORT
^ CITY OF BLAIR ^ WA HIND N CO/fUN~Y ^ OTHER
LOCATION OF INSPECTION: ~~ / ~(t c~~~` .~ ~i~
NAME OF OWNER: ~L'~ / ~ 0~ ~~~ rnNTU e~Tnu
DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED: ~ ~ PERMIT N0: ~ ~~
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASSED FAILED
COMMENTS: _ J~~~ ~Q f(~L~ / ~ ^
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:
OF INSPECTION MADE:
FAXED OPPD~BURT REA
TO CONNECT SERVICE: ON
TIME: ~ ~ `
BY
CITY OF BI,~1IR
~~
o~/se of
BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet includes various items dealing with particular code
requirements and/or building permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2000 International 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. A copy of the
International Building Code is available for your use at the Blair Public Library.'
have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner/contractor for this project.
Owner/Occup nt
City of Blair
Contractor
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel,net `m