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BP9666. j~-e~ z (~ I o~ ,~-~ 133 City of Blair Building Permit Detail Permit #: 9666 Issued: 3/15/2002 Type: Residential Remodeling .Completed: 2/6/2003 Valuation: 120000 Location: 505 North 19th Street Owner: Steve Petersen Permit Fee: 555 Address: 16050 Co Rd 25 Issue Fee: 15 Deposit Amt.: 200 Blair, NE 68008 Receipt #: 6593 Phone: 402-426-5231 Section: Township: Range: Subdivision: Lot: Block: new foundation -move back 10' -replacing all windows -egress/bedrooms & bsmt - reframing interior walls - replacing 2 stair cases -replace exterior doors. Contractors Petersen Concrete & Masonry, Inc. Beebe Refrigeration, Htg. & A/C, Inc. Blair Plumbing Blair Plumbing DicKs Electric Co. Remarks 3/15/2002 ROD 2/6/2003 DEM Inspections Date By 4/3/2002 DEM 5/10/2002 DEM 5/22/2002 AL 5/22/2002 AL 5/22/2002 AL 6/18/2002 DEM 6/18/2002 DEM 6/18/2002 DEM 7/12/2002 DEM 7/12/2002 DEM 7/12/2002 DEM 7/12/2002 DEM 9/24/2002 DEM 2/6/2003 DEM 2/6/2003 DEM 2/6/2003 DEM 2/6/2003 DEM General Contractor Permit # Issued Heating Subcontractor M0797 6/6/2002 Plumbing Subcontractor P0737 5!20/2002 Plumbing Subcontractor P0727 5/8/2002 Electrical Subcontractor E1586 6/6/2002 per agreement to be completed by July 1, 2002. Occupancy Granted Footings Pass Plumbing Groundwork Pass Sewer Lines Pass Water Service Pass Water Tap Pass Plumbing Rough-ins Fail Framing Fail Electrical Rough-ins Pass Electrical Permanent Service Pass Mechanical Rough-ins Pass Plumbing Rough-ins Pass Framing Pass Drywall Pass Plumbing Final Pass Final Inspection of Project Pass Electrical Final Pass Mechanical Final Pass ~~ BUILDING PERMIT APPLICATION ~ ~ Jurisdiction of City of Blair, Nebraska Permit Fee: `~ ~7©, Q® 218 South 16th Street Issuance Fee: ~-~~ ~ Blair, Nebraska 68008 9 6 6 6 Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit Deposit Receipt #: ~9 Issue tate: ~~~ ` "~ Type: S 1~U r ri JOB ADDRESS ~ ~ /v''I {~ ~ O ~~'^ ~ a~J ~~ V~ 7l 'J LEGAL 1 . DESCR. ^ SEE ATTACHED SHEET 2 OWNER ~ Q L ~ MAIL ADDRESS~~ CU ~L ~ ~ ZIP HOME PHONE `~ WORKICELL PHONE ~Ztl~''~ ~ ~ 1 3 CONTRACT ~ Q~ n ` ~~n Y `S ZIP l HOME PHONE ~ q~ _ ~ ~~ WORK/CELL PHONE G 4. Class of Work: ^ NEW ^ ADDITION REMODEL - ^ OTHER 0 FINISHED BASEMENT O UNFINISHED BASEMENT 5. Describe Work: ~ ~ ~, _ ~ ~, j ~~ ~ ~-. ~S ~ ~- ~slm-~ - ~- turn t'~ fie.. ~ o r (~,~Is - 1 ~ i r C'Gtses , ~ lQ ~ e ri / ~S ~ IV~(xJ~ -I10~cSe c~c.k I b' 6. Valuation of Work: $ ,a© d~~ Total Sq, Footage (IRDIudiRg Ba6emeRt aRd Garage): Total Finished Area: Floodway ^ Yes 7. Floodplaln: Fringe ^ Yes ^ No Dev. Permit ^ No BFE Elev. Cert. 8. Current Zoning: ~~ 9. State Fire Marshall Required: Q Yes ~ No 10. Special Use Permit Required: Q Yes [~j No 11. Variance Required: 0 Yes ~o 12. Minimum Setbacks: Front ~ 1? Side I (~ Rear ~rL Q Site Plan Attached 0 Com lete Plans Attached Approximate Completion Date ~ ` ~ Inspections Required and Fees Utilities er_ Septic _ 13. Sidewalk Required: 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''1 Inspector. I hereby agree to perform the proposed work in accordance with the specifications sett 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 days or is not completed within 2 years of date of issue. .~ % ~- vz. SIGN RE O ER/CONTRACTOR DATE Comment: MEET IBC, IRC, IpC, IMC ~Np NBC COQE REQUIREMENTS SLEEPING ROOMS gE(.OW THE FOURTH ..STORY AND IN BASEMENTS ARE REQUIRED TO HAVE AN EGRESS WINDOW. Buildma - Fo~rrt Fr Ing - Watsr~rvice ~`C ox Card Drywall (PRIOR TO TAPING) Electrical Vie, Rr'~-in Fi~ures~ .~ ~~~ Parmarrnr~l'Sarvira Tempor ervice Mechanical _ R~gIS ~I Plum in Gr. Work ~. WHEN PROPERLY VALUaATED (IN THIS CEO IkIIS IS YOUR PERMIT 2 ~.._ - - Rev. 6/96 POUNDS PRIG: Blair, NE ~~ ~ PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 P ~ 7 3 (402) 426-4191 ,~/~~ ~irr~ ~~~~~ Application Date: ~ ~ ~ ~~ ~ Permit Fee: $ ~~ JOB ADDRESS ~... 1 , py~ E MAIL ADDRESS ZIP PHONE ~ P Su n 2 CONTRACT~d~'^ 9 I ~~; MAIL ADD_E~~ ~ ~~ PHONE ~ ~~~ LICENSE NO. 3. Class of Workll: O COMMERCIAL 1 RESIDENTIAL(„~~ NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT 4. Describe Work: ~~ ~- -~ ~~~ ~~ ~~~ ,~ r- ~~_~___ Comments: PLUMBING PERMIT FEES Modular Home ...................... $15.00 Type of Fixture NOTICE I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws 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. S GNATURE OF CONT CTOR OR AUTHORIZED AGENT DATE 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 Sewer .................................... $10.00 Groundwork ........................... $10.00 Septic Tank & Laterals .......... $10.00 Lawn Sprinkler System ......... $10.00 Sprinkler System ................... $30.00 (Commercial) Gas/Water Piping System (Commercial) ........................... . $30.00 Permit Issuance Fee ............. $15.00 Current License on File [Yes No. _~ ~ l~?,~ ~ f c7 ~~ (;erg T° ~~ . TOTAL ~•U~ O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved ~y• I Rev. M98 POUNDS PRTG.~Blair, NE PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 Application Date: ~~~s-~ ~ P 0727 Permit Fee: $ 5~,~° JOB ADDRESS ~O ~ ` ~ + ' ~[,~~ ~~ 1 . OWNER ~ MAIL ADD~S~ ~ , / % ~I ZIP !ti(r ~~~ ~ PHONE 2 CONTRACTOR ~ ~ ,~ ~ MAIL ADDRESS ~ PHONE _~~ ~ ~ LICENSE NO. 3. Class of Work: O COMMERCIAL RESIDENTIAL O NEW ADDITION O ALTERATION O REPAIR O REPLACEMENT 4. Describe Work: ~(~d~ ~ ~ • ~ /~ ,~ r~~ JC gq C mment~YL`"~ ~0 PLUMBING PERMIT FEES Modular Home ...................... $15.00 Type of Fixture No. Kitchen .................................. $8.00 x I $~ ® b Bath ....................................... $8.00 x ~ I(o.0(7 Rough-In Bath ....................... $4.00 x Slop SinWLaundry Tray ......... $5.00 x ~ ~' 00 Water Heater ......................... $3.00 x Outside Water Faucet ........... $3.00 x Drinking Fountain .................. $3.00 x Water Service ........................ $10.00 NOTICE Sewer .................................... $10.00 I hereby certify that I have read and examined this Groundwork ........................... $10.00 ~ ~ ~ ~ ~ 6 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 (Commercial) ........................... . $30.00 Permit Issuance Fee $15.00 s'®D ~ SIGNATU OF CO NTRACT OR THORIZED AGE ~ a ' ~~ TOTAL `~ p ~ ~L/ DATE Current License on File Yes O No O NA WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By: ~~~ MECHANICAL PERMIT APPLICATION ~~ Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 O 7 9 7 Fax (402) 426-4195 M (402) 426-4191 Application Date: (f~-Ca~~~ Permit Fee: $ ~O ~'UC~ JOB ADDRESS ~~ ~ ~ ~~ ~~ 1 OWNER ('. \ ApA L ADDRESS ZIP ~ HONE ~ ~ ~~ C° ,Z CONTR TOR MAIL ADDRESS PHONE LICENSE 0. ' q~l, g ~ 1 ~ C ~ ~+- ~1 ~ - i~ e~ [t, r~n r 3. Class of Work: O COMMERCIAL O RESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT 4. Describe Work: ~ ~ ~ ~ ~ ~ ~ -~~., U~i(SV ~~ Central A/C ~ ° ~ Tons MECHANICAL PERMIT FEES ~~}} Furnace `~t~ ~~~~' BTU/H ~~a0 Forced Air/Heat Pump Systems -Per Unit - Commercial/Residential (New) .................................................... $25.00 # of Units A/C Air-Conditioner Unit -Per Unit ~ f_ d~ Furnace Commercial/Residential (New) .................................................... $10.00 Forced Air Systems/Air Conditioner (~ ~~ C l i D 1 Unit Replacement Per Unit Commercial/Residential ................... $10.00 omp et on ate: Refrigeration Units/Coolers/Lines/Compressor - Per Unit Commercial (New or Replacement) ...... ..................... $10.00 Comments: Appliance Vent/Fans ............................... $10.00 Boiler ....................................................... $15.00 ~ Duct System ............................................ $10.00 ~ ~ _ Gas/Air Outlets .................. x $2.00 NOTICE Radiant Heat Systems ............................ $25.00 I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Modular Home $15 00 work will be complied with whether specified herein or not. ......................................... . Th e 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 Permit Issuance Fee ............................... $15.00 t ti cons ruc on. TOTAL CoC1~ Or SIGNA RE OF CONTRACTOR OR AUTHORIZED AGENT Z~~~ Current License on File ~1 Yes O No O NA DATE WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved B .~ POUNDS PRTG: Blair, NE Rev. 4/98 ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 Permit E 15 8 6 Application Date: la-~lG --ta Z Permit Fee: $ r~~s~ JOB ADDRESS ,r-~~ ~ • ~ O 1 LEGAL p SEE ATTACHED SHEET DESCR. 2 OWNER ~ MAIL ADDRESS ~ ~ ~ ~ ZIP ~ ~ C ~ `° /~~ c. W l~ WORK/CELL PHONE `i Vw 3 CONTRACT ~, ' MAILADDRESS PHONE HOME PHONE WORK/CELL PHONE 4• Class of Work: O NEW RESIDENTIAL D NEW COMMERCIAL REMODELING/ADDITIONS O UPGRADE SERVICE 5• Describe Work: ~~ ~ ~, ,~' 6. Current License on File ~ No O A Completion Date - 2 ELECTRICAL PERMIT FEES New Service Fee = (Amp Fee + $2.00 per branch circuit) 1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00 p~ • b~ 101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00 201-300 Amp Fee ............................ $ 30.00 Fire Alarm S stem $10.00 y 301-400 Am Fee $ 42.00 p ............................ Signs •••••••••••••••••••••••••••••••••••••$15.00 401-500 Am Fee $ 55.00 p ............................ 501-600 Am Fee $ 67.00 p ............................ Miscellaneous Apparatus ...... $11.00 601-700 Amp Fee ............................ $ 80.00 AC/DC Circuit ........................ $5.00 701-800 Amp Fee ............................ $ 92.00 801-900 Amp Fee ............................ $105.00 Commercial/Multi-Family and All Upgrades: 901-1000 Amp ................................. $117.00 # of Circuits x $2.00 IF OVER 1000 Amp Amp Fee 1st 1000 Amp Fee ....................... $117.00 Each additional 100 Amps ........,.. $ 13.00 Amp Fee + Circuit Total New Residential: (Finished Area) NOTICE Single/Two Family Dwellings I hereby certify that I have read and examined this ~Oa sq. ft. x .045 ~~ ' ~~ application and know the same to be true and correct. All provisions of laws and ordinances governing this type of Modular/Manufactured Homes ....... $30.00 work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority Receptacle/Switch Outlets to violate or cancel the provisions of any other state or local Fixtures x $.75 law regulating construction or the performance of Smoke Detectors x $3.00 construction. Residential/Commercial Appliance # Fixed Outlets x $3.00 Motor(s) x $3.00 ~ Power Apparatus (220 Volts) SIGNATURE OF CONTRACTOR OR AUTHORIZE GENT # Apparatus x $3.00 -~ ~ ~ -^•n ~- Permit Issuance Fee ............. $15.00 ~ ~ ~~ DATE TOTAL LdS, SCE WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approved By; SOUNDS PRTG.-Blair, NE Rev. 11/9£ ,. ~ BUILDING INSPECTION REPORT a. ^ CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER LOCATION OF INSPECTION: ~j b `--~ ~ I ~ ~~ 1 `~ ~ ~ `a -~ I ~. I ~-V ~>'~~ CONTRACTOR: ~~ '~~ ~ ~,{~':~ ~> ~ ~l ~~ (~)"~r 1~ NAME OF OWNER: DATE INSPECTION REQUESTED: ~ ~ ~ ~ ~ (~ TIIvIE INSPECTION REQUESTED: I I' ~ PERMIT N0: ~~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASS FAILED COMMENTS: MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT FINAL ^ PARTIAL COMMENTS FAILED PLUMBING: ^ GROUNDWORK ^ ROUGH-IN FINAL ^ WATER METER INSTALLED ^ PARTIAL PASS FAILED OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: TIME: ~~ r! r FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY ~° BUILDING INSPECTION REPORT ~~ CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER LOCATION OF INSPECTION: ~lJ --~ ~~ ~ ~ ~ I ~fi ~~ NAME OF OWNER: `-( ~~~~ {~~;~-C" ~~ J b Y~ CONTRACTOR: ~ - ~~^ ~'> _ ~ ~ "~ DATE INSPECTION REQUESTED: C~ ~ ~ ~ TIME INSPECTION REQUESTED: I ~ ' w ~ I PERMIT N0: ~`*~~`~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING i DRYWALL ^ FINAL ^ PARTIAL COMMENTS: PASSE FAILED UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE- ^ WATER SERVICE ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: r C/ ~~V DATE OF INSPECTION MADE: ~ ~ TIME: FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT ~, ^ CTI'Y OF BLAIR ^ WASHINGTON COUNTY ~ ~,/ ~ ^ OTHER/ LOCATION OF INSPECTION: ~ l y~' r~~ ~ / ~/ f ~? ' -~~ I ~~ NAME OF OWNER: \ ~ ~ ~;~ V ~~7~ r`~ ~~ ~ CONTRACTOR: l ~f DATE INSPECTION REQUESTED: Ll ~ .~J r)~ TIME INSPECTION REQUESTED: / ~ , i PERMTI' N0: ` ~~ ~~ ~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL 1 COMMENTS: PASSE FAILED ^ UTILITIES: ^ SEWER TAP ^-SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE ^ PARTIAL COMMENTS: "' f PASSED ^ FAILED ^ ELECTRICAL: ^ ROUGH W ^ FINAL ^~ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ PLUMBING:. ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL COMMENTS: PASSED ^ FAILED ^ ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: DATE OF INSPECTION MADE: _ TIME: ~C (CJ( J FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY a BUILDING INSPECTION REPORT _- . ~~ ~ ^ CITY OF BLAIR ^ WASHINGTON COUNTY ~ ^ OTHER LOCATION OF INSPECTION: SOS ~ " ~ /~ NAME OF OWNER: ' ~/~ ~~~ CONTRACTOR: l ~/- DATE INSPECTION REQUESTED:-/~~ Q~ TIME INSPECTION REQUEST /Q ~(©~ PERMIT N0: ~`~ 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 ^ WATER SERVICE PASSED FAILED ISARTIAL ; ;. 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 PASSE FAILED COMMENTS: ^ ;OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED b ., NOTES/REMARKS: INSPECTO DATE OF INSPECTION MADE: D ~ TIME: ~ ~~ FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY P BUILDING INSPECTION REPORT ~- CITY OF BLAIR ^ WASHINGTON COUNTIY 11 `^' yOT~HER LOCATION OF INSPECTION: Q I NAME OF OWNER: ~ ~' ` ~~ I~ ~~~ CONTRACTOR: ~ ~~ t Y ' ` ~'~ hL ~~ ~~ /.! DATE INSPECTION REQUESTED: ~ 12Z ~ ~ Z- TIME INSPECTION REQUESTED: t I ' d~ y ~' / l PERMIT N0: r'~2S - ern TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL COMMENTS: ^ PARTIAL PASSED ^ FAILED ^ UTILITIES: ^ SEWER TAP SEWER ^ SEPTIC WATER TAP ^ REMOTE ^ PARTIAL COMMENTS: ATER SERVICE PAS~D FAILED ^ ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PARTIAL COMMENTS: ^ PRECONNECT PASSED ^ FAILED ^ MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL COMMENTS:.- PASSED ^ FAILED ^ PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED COMMENTS: ^ PARTIAL PASSED ^ FAILED O ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: INSPECTOR• DATE OF INSPECTION MADE: 2 ~ 2-- TIME: ~ ~ rit FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY Q BUILDING INSPECTION REPORT ~CTI'Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHER LOCATION OF INSPECTION: ~ ~ ~~ ' ~ `~ v 1 ~~~-Q.~S~ ~-P ~~ ' ~ coNTRACTOR: ~~ i ~ ~C~ ~ ~ ~ ~-[ moo- ~-1 b I ~, NAME OF OWNER:. 9 ~ DATE INSPECTION REQUESTED: ~Y ~ ~ v r y ~ TIME INSPECTION REQUESTED: ~ ~~~-n-v V ~ 'PERMTI' N0: ~ " TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILE COMMENTS: 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 FAIL ^ COMMENTS: ^ OCCUPANCY GRANTED ^ NOTES/REMARKS: TIME: / ~` r ~~ ~. ../ FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY w BUILDING INSPECTION REPORT ^ CITY OF BLAIR ^ WASHINGTON COUNTY ^7O~THER LOCATION OF INSPECTION: '` ~ + 4~ ~ ` NAME OF OWNER: ~~° ~ ~ ~~~ CONTRACTOR: ~"~- ` '` Y~~ J~ ~ ~3 y " I C1 DATE INSPECTION REQUESTED: ~ t ~ ` ~ ~ TIME INSPECTION REQUESTED: ~~ ~r ~-~ ~ P~ PERMIT N0: ~~~'"" TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING [~f~' FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASS FAILED r ^ COMMENTS: UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ~' ELECTRICAL: ^ ROUGH IN ^ FINAL PERMANENTS VIE ^ TEMP~O/Y VICE ^ PRECONNECT PASS FAILED ^ PARTIAL ( ~~~~L/ ^ COMMENTS: MECHANICAL: ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASS FAILED COMMENTS: PLUMBING: ^ GROUNDWORK ~ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PAS D FAILED COMMENTS: ~ r' ! j~ ,~,~ ~h' ~ ~ 1 (~~ / ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: ~, ~ INSPECT / TE OF INSPECTION MADE: ~~^ ~~ TIME: ~ ~ AXED OPPD\ URT REA TO CONNECT SERVICE: ON BY ~ °IZ-~~ ~ CITY OF BIdllR -~ ~r0 J~`~~ ~~se of G ~UiL©if~G PERf4~IT ®EPOSIT ~4GREEf~~ER1T ~ $200.00 refundable deposit is being collected at the #ime of your building permit application for all permits in excess of $'10,000.00. However, the City reserves the right to not refund this deposit if any of the following conditions occur during the construction period: ~~ the~~ ofwater service by eitherthe piur~~ber, owner or general contractor, 2) all required- inspections have not been obtained (this includes drywall prior to taping j, ~) occupancy occurs prior to a anal inspection, 4~ all perrnif~ have not been obtained, and ~~ the project is completed without a nnal inspection being done. if any or all of these situations occur during construction, you may for:`eit your deposit. i, hereby agree to the above conditions, and understand #hat should any or ail of the above situations occur, the building permit deposit ~H~~l_ be forfeited or discounted upon the discretion ofi the City of Blair, ~suifding and inspections Cepariment. Contractor/Owner ~ ~S~ ~~ Qate Ccntractor/owner City of f3fair 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cilyofblair@huntel,het ~~ ~, ,~.az ~ +4 ~J~ O~ ~ promise Blair 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 Uniform 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. The Uniform Building Code is available for your use at the Blair Public Library. I 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/Occupant Ci of Blair Contractor r/~~ Date c~~ of 218 S.16TH STREET, BLAIR, NE 68008.2010 • (402) 426.4191 ~ (402) 426.4195 FAX • E-MAIL: cityofblair@huntel.net f f L lr1 U a t~ ~_ _~ Uy C7 1 r s 0 I r T T ~S • ti ~rii' ~ "'~' ~ _~ ~ ~ Z o ~ ~ ~ ~ ~ N .^ '! ~ I~ , i~ I i r _.~. Ir (//1 1 ~ s~"° a~ !tom pcr ~-G. Con c/ c C~ ~ _o ;~ ~1i ~1 ~ _. _ ~~ r r-C s N °~ S4 `~ C+ ~ z ~ -- ~ a ~- ~ o ,~ N s 1 cc~ ~ b o c _~ ~- o S o p N y s ~ Q ^ n ~~ C ~ ~ C N a W ~- 4 1 1 ~s ~- A r S ~ ~- c .~. A •~ 17 ~ `t ~~ 1 ~° Z ~ II ~, ~U ~ ..-,. ~, r o r (~ N r s S ~~ N m\ ~~ ~i .~.. N i 1 l ~'y ~ j _ a .~ -`~ ~ 1 ~ S~ 1 r ~' _ r ~ _ O ~ s -~ ~ r 3 S+a~ J i . ~ fi ~ n ~o ,~ ~+ N 1 G ~ ~ ti ~ ~( E C ~r~ n r H ~- Cs ~ F ~ 0 s BUILDING PERMIT APPLICATION Permit Fee: Issuance Fee: _ Receipt #: Deposit Receipt #: Issue Date: - Type: JOB ADDRESS LEGAL 1 . DESCR. ~ ~ f 3 ~ . t ~" I (~~ ,~j Z >f .L-C•~ ,yi ~~ j ) , I (~:'C "r'~' JC%C~•L`~ C i~~ ^ SEE ATTACHED SHEET OWNER _-~ ~ 2. ~dN ~ ~ ~-~-r~/~~ ~ ~. ,MAtbADDRESS ZIP yVORKICEOLLPHONE CONTRACTOR `3, MAILADDRESS ZIP HOME PHONE WORKICELL PHONE 4. Class of Work: ^ NEW ^ ADDITION REMODEL ^ OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT 5. Describe Work: <- 6. Valuation of Work: $ Total Sq. Footage Qncluding Basement ana Garage): Total Finished Area: Floodway ~. Floodplaln: Fringe ^ Yes ^ Yes Q No ^ No Dev. Permit BFE Elev. Cert. 8. Current Zoning: 9. State Fire Marshall Required: ^ Yes 10. Special Use Permit Required: ^ Yes 11. Variance Required: ^ Yes ^ No ^ No ^ No 12. Minimum Setbacks: Front Side Rear _ 13. Sidewalk Required: ^ 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 acknowledge that payment of the building permit application fee does not constitute issuance of this building permit. I furtheragree that construction covered by this permit application shall not be commenced until I have received a copyofthis application form signed bythe 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. tvndersFatjdthatthispermitisnaieti#~vvorfFis~aotcoa~r~eRSedwitMin f8 q~s-nat-eor~ leted-wi#hin~-yearsv a~~iss~2: ~!' ~~/~`!'s~~n~ f~r' l'ur~l/~~E"~v by fu/~ r, :~ UoL . ~ SIGNATURE OFOWNER/CONTRACTOR Comment: DATE ^ Site Plan Attached ^ Complete Plans Attached Approximate Completion Date Inspections Required and Fees Utilities Sewer Water Service Septic Remote Stop Box Card Building Footings Drywall (PRIOR TO TAPING) Framing Final Elec rical Rough-in Fixtures Final Permanent Service Temporary Service Mechanical Rough-in ABC Final Plum in Ground Work Rough-in Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Approved By: POUNI]S PRTf:.-Rlair. NE Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 (402) 426-4191 • Fax (402) 426-4195 Rev. B/96 02~19J2002 10:40 14024264848 PAGE 02 AGREEIV~ENT THIS Agreement emtered into by and between the City of Blair, Nebraska, a lVlutticipal Corporation, hereinafter Referred to as "City" anal Steven P. Petersen and Christixte ~. Peterseta, husband and wife, hereinafter referred to as "Petersens". WHEREAS, a lawsuit is currently pending in the District Court of Washington County, Nebrasl~a entitled City of Blair, Nebraska vs. Gary L. Poulson and Sally J. Baertschi, Case No. CI O l -260, pertaining to nuisance violations and building code violations ott the following described real estate, to-wit: The North Half of I,ot 3, Block 13, Dexter's Second Additio~a to the City of Blair, Washington County, Nebraska, AND the South Half of Lvt 3, Block 13, Dexter's Second Addition to the City of Blair, Washingtont County, Nebraska ("Subject Real Estate"). WHERE,A,S, Petersens desire to purchase the subject real estate and in order to induce the City to issue a building permit and otkter required pet•rnits and furthermore, to induce the City to tet~iporarily postpone action vn the above-referenced lawsuit, Petersens agree to execute artd deliver this Agreetxaent and to titxtely comply with the terms and provisions hereo£ FOIE VALUABLE CONSIDERATION, and the txtutual covenants aztd promises hereitx, t17e parties hereto agree as follows, to-wit: 'f e~n~orary Postponement of Law nit. The City agrees to temporarily postpone action on the above described lawsuit until July, 1, 2002. In the event that Petersens have complied with the terms artd provisions of this ,Agreement, on or before July l , 2002, City agrees to distxtiss its lawsuity provided however, in the event Petersens are in default of any of the terms and provisions of this .Agreement, thexa City sl~ali be exttxtled to proceed with the lawsuit in accordance with this Agreement. 2. ,A,bate ent of Nuisance and Code ViolatiQ~s. Petersens do k~ereby agree that on or before July 1, 2002, they will abate or cause to be abated all building code, electrical code, mechanical code artd fire code violations which exist ott the subject real estate, and also to rernove or remedy axty zauisances, as defined by Municipal Code Sectioat et. seq. aztd et. seq. Set Bach of ouse. Petersens agI'ee to t•elocate the foundation of the house and place the house on top o~such foundation, at a location which is at least ten (1 O) feet back from the existing location ofthe house and foundation (i.e. house is to be nxoved ten {10) feet farther back front the front lot line). 4. Funding of I-Iottrte Improvements. Prior to making applications for building permits, Petersexs agree to provide the City Administrator with proof satisfactory to the City 02/19/2002 10:43 14024264848 PAGE 03 A.dministratox that Fetersens have adequate financxz~g necessary to purchase tlae subject real estate a,nd to make all repairs and perfoxim all ia~oproveznents to the subject real estate. 5, Defaults, In the event that Peterseaas do atot tiaxaely perfva-m or cause to be performed all acts necessary to abate all nuisances and codeviolations set forth above, aaad furthermore tv complete all izaaprove>7r-ents set forth izt the building perzziit, oat or befvxe July 1, 2002, City Wray, at its optioaa, termizaate the building permits azad all othex permits issued to Peterserls for away improvements vn the subject real estate aatd to proceed with litigation of the pendiaag lawsuit, 6. Time is of the essexxce. Dated this day of February, 2002. CI"fX OF BZ,AIR, NEBRASKA By MICHAEL A. MINES, MAYOR Steven P, Petersen Claxistine D, Petexseia ATTEST: BRENDA R. T,A,YLOR, CITY CLERK