BP9437~~ ~~~? ~1 ~ 3 i ,~~ ~~ l y
City of Blair Building Permit Detail
Permit #: 9437 Issued: 11/19/2002 Type: Residential -New Construction
Completed: 08/06/2003 Valuation: 220000
Location: 910 N. 14th Street
Owner: Byron Peterson
Address: 714 N. 14th Street
Permit Fee: 925
Issue Fee: 15
Deposit Amt.: 200
Blair, NE 68008 Receipt #: 8018
Phone: 402 426 4738
Section: Township: Range:
Subdivision: KORSHOJ Lot: Lot 6 Block:
One story ranch, 2 bedrooms, 3 car attached garage, unfinished basement, 2 bathrooms, rear covered porch, 1
egress window
Contractors
Nielsen Construction Ca General Contractor .Permit # Issued
Chapman Mechanical Services, Inc. Heating Subcontractor M0909 02121/2003
Chapman Mechanical Services, Inc. Plumbing Subcontractor P0882 02121/2003
Dick's Electric Co. Electrical Subcontractor E1695 12/02/2002
Henton Trenching, Inc. Plumbing Subcontractor P0852 12/16/2002
Remarks
Inspections Date By
11/27/2002 ICAR Footings Pass Partial
12/03/2002 DEM Electrical Temporary Service - Pass
12/12/2002 DEM Footings Pass
12117/2002 DEM Water Service Pass
12/17/2002 DEM Sewer Lines Pass
02/21/2003 DEM Plumbing Groundwork ~ Pass
03/20/2003 DEM Mechanical Rough-ins Pass
03/20/2003 DEM Electrical Rough-ins Pass
03/20/2003 DEM Plumbing Rough-ins Pass
03/20/2003 DEM Framing Pass
04/0212003 DEM Drywall Pass
08/06/2003 DEM Temporary or Final Occupancy' Pass
08/06/2003 DEM Final Inspection of Project . Pass
08/06/2003 DEM Electrical Final Pass
08/06/2003 DEM Mechanical Final Pass
08/06/2003 DEM Plumbing Final Pass
BUILDING PERMIT APPLICATION
y~5 v~ Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: I,S ~~ ~'~ Blair, Nebraska 68008 9 4 3 7
Receipt #: o ~ ~ (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #:
Issue Date: ~ ~~ ~ s U ~" ~ Type: ~~~/«~C/J~/C/~ ")W ~V~ (A~~ 1/"c~~7/dYl
JOB ADDRESS ~/~ /` ' . f ~~ ~~
v
LEGAL
1 . DESCR. 1
n n ~ -
~ ~ \ ~ ~
^ SEE ATTACH
E
D SH
EET
2 OWNER ro~ n
I_ ~ / ~ AIL ADDRESS _ ~ ~~ , ~f~r n r~
(
~ / V 7
/
/
yyORKICEOLL PHONE ~7 ~~D"- y /j
CONTRACTOR
'3, ~ MAIL ADDRE
SS
ZIP
,`~ 3 ~ a"~l ~ &.0 ~ ~' HOME PHONE y
WORKICELL PHONE ~. ~ M,p- a () S ~]'
4. Class of Work: NEW Q ADDITION O REMODEL Q OTHER Q FINISHED BASEMENT ,UNFINISHED BASEMENT
5. Describe Work: ('~ QQ,Y,.,~ ;~ "j (~,~" ca ~ ~
6. Valuation of Work: $ ~~ u~a Total Sq. FOOtage (Including Basement and Garage): ~~ ~ ~ Total Finished Area: ~ Q (~
Floodway ^ Yes
7. Floodplain: 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 ~No
11. Variance Required: p Yes ~No
12. Minimum Setbacks: Front ~ Side ~ Rear,~~
13. Sidewalk Required: Yes Q 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
Stateo raska.lunderstandthatthispermitisvoidifworkisnotcommencedwithin
ays or i not comp~dXvithin 2 years of date of issue.
OF
DATE
Comtmaternrt~ ~r t ~w
tY1LG( ~~,m~i.i~f~1-fla~{W"CI)i~
,~~ING ROOMS BLOW TM~ FOURTH
STORYAND IN EASEMENTS ARC
O Site Plan Attached 0 Complete Plans Attached
Approximate Completion Date ~ ~~-
Inspections Required and Fees
Utilities
S r Wa rvice
Septic Ra~
St ox Card
Building
F moor" gs p
F iFa~ ng -
Electrical
RIOR TO TAPING)
Ro - n Fes'
~ Pe~an~nf Service
Te~perar~~rvice
Mechanical
Rou - n ,ktf
Plumbin
Grog ork
WHEN PROPERLY VALIDA
IS
NE _~"____._.._w__,___-. _ Rev. 8196
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 0 9 0 9
(402) 426-4191
Application Date: ~ ~~ ~'U
Permit Fee: $ llJt~ -~
JOB ADDRESS ~ ~Q ~ -
1 . OWN ~~ ~~ ~/~_~~~ MAILADD~ ~ `~ ~ ~ ~ `~ ZIP
d t~ P 0 E _
r
2 CO TRACTOR MAIL ADDRESS PHONE ,, II LICENSE N0.
3• Class of Work: O COMMERCIAL .L~JhitSIDENTIAL ~EW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4• Describe Work: ~C~ ~ .~ ~~~ ~""" ~ ~ ~~~ ~~
Central A/C ~ Tons MECHANICAL PERMIT FEES
Furnace ~~t~ ~~-~ BTU/H Forced Air/Heat Pump Systems -Per Unit ~~i~~ ~
# of Units A/C Commercial/Residential (New) .............................................. .... $25.00
Air-Conditioner Unit -Per Unit 1 ~ ' U ~
Furnace Commercial/Residential (New) .................................................... $10.00
Forced Air Systems/Air Conditioner
Completion Date: Unit Replacement Per Unit Commercial/Residen tial ................... $10.00
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
li
i
d k
app
cat
on an
now 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. .........................................
.
The
r
ti
f
it d
g
an
ng o
a perm
oes not presume to give authority
to violate or cancel the provisions of any other state or local r~ ~~~
law regulating construction or the performance of Permit Issuance Fee ............................... $15.00
construction
.
TOTAL
~ ~~~
~
~
~
IG OF CONTRAC OR OR AUTHCAIZED AGENT
~2 -•~ d - c7.~ Current License on File es O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG.-Blair, NE Rev. 4/98
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 P 0 $ $ 2
(402) 426-4191
1~~
Application Dater ~ ~ I
Permit Fee: $
,~~o~
JOB ADDRESS
~~ ~ ry ~ d ~ T~1~
" ~~~~ ~ "~II,QDD ESS
'
~. 0 ~ ~lJ
I 1 .~~
l ~P PHON
~~ ~
l
A ~I C
0
RACTOR MAIL
DDRESS
2. ~ I Y r PHONE
' ~ ~~ LICENSE N0.
~ ~ i~
y',•(~
~J
3. Class of Work: O COMMERCIAL RESIDENTIAL EW O ADDITION O ALTERATION O REPAIR
O
REPLACEMENT
4• Describe Work: ~ ~Y ~
' U
Comments: PLUMBING PERMIT FEES
Modular Home ...................... $15.00
Type of Fixture No~ ~ ~~
Kitchen .................................. $8.00 x
l~ ,~ ~
Bath ....................................... $8.00 x
~
~' ~~'
Rough-In Bath
....................... $4.00 x
Slo Sink/Laund Tra
p rY Y .........
$5.00 x _~ `~' ` ~ ~
Water Heater ......................... $3.00 x
c~
~ ,~~~
~ ~ ~'~~
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 ~ ~~~~~_
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
_~ G Permit Issuance Fee ............. $15.00 ~~ ~C~
S NATURE F CONTRACTOR R AUTHORIZED AGENT TOTAL ! ~ ~ C/U
DATE Current License on File ~fes O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
Wu
POUNDS PRTG: Blair, NE Rev. 4/9B
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: 12 ~ I~ laZ
P 0852
Permit Fee: $ 3~ Oy
JOB ADDRESS ~ ~ I ~ T~.~
A
ER ,O I a MAIL
DDRESS / ~ I ,,
1. ~ ~ ~v>1 + -e1~{~ SQ~V~ ~ ~~ N ~`r~~ ~T. ~lS~( Z~
~L
PH NE p~~
CONTRACTOR MAIL ADDRESS PHONE
2.3 ~-tor-, o u
-~ LICENSE NO.
~ ~~
3. Class of Work: O COMMERCIAL PRESIDENTIAL NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4. Describe Work: ~~ ~ ~ ~ ~~ ~ (/ ~ C_Q_, ~ ~ ~,~
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~
....................................
Sewer $10.00 I ~ ~ ~~
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
(Commercial) ............................ $30.00
Permit Issuance Fee ............. $15.00 ~~'~
NATURE OF CO RACTOR OR AUTH E AGE T
TOTAL .~ ~
DATE Current License on File es O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
Rev. M98
POUNDS PRTG.~Blair. NE
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit E
Application Date: ~ ~ ~ o` ~ ~
Permit Fee: $
1695
JOB ADDRESS
1 u N .- lye ~.
LEGAL
1 • DESCR.
O SEE ATTACHED SHEET
2. OWNER MAILADD ESS ~ ZIP HOME PHONE t 1 -1 (y
a I
'
~
~
P
~
"
~ r~
ly - ~
(
-
~ ~
-
~
~--
• WORK/CELL PHO
~
o S
o p -~
NE
1
I
b
,3 CONTRACTOR ~a MAIL ADDRESS PHONE HOME PHONE
[ WORK/CELL PHONE
4. Class of Work: NEW RESIDENTIAL O NEW COMMERCIAL p REMODELING/ADDITIONS O UPGRADE SERVICE
5• Describe Work: PV.Q~ ~- ~~ ~~~
6. Current License on File ('Yes p No p NA Completion Date
New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00
101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00 ~ ~ • ~
201-300 Amp Fee ............................ $ 30.00 Fire Alarm System ................. $10.00
301-400 Amp Fee ............................ $ 42.00
Signs ..................................... $15.00
401-500 Amp Fee ............................ $ 55.00
501-600 Amp Fee ............................ $ 67.00 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 Siryngle/Two Family Dwellings
~ ~
I hereby certify that I have read and examined this o~ l) 9 ~ sq. ft. x .045 • ~ S
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
ill b
li
d
ith
h
th
ifi
d h
t
i
w
e comp
e
w
w
e
er spec
e
ere
n or no
.
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 0 AUTHORIZED AGENT # Apparatus x $3.00
- `b ~ ~ Permit Issuance Fee ............. $15.00 I ! ~, 0 O
DATE A
TOTAL I ~ ' V
1
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG: Blair, NE Rev. 11/99
~- ~ BUILDING.INSPECTION REPORT
~ITY OFBLAIR ^ WASHINGTON COUNTY - ^ OTHER
//////LOCATION OF INSPECTION: '1` ~ ~ , `~ f 1 ~ ~L{
NAMl~ OF OWNER: ~ ~ ~r`~-~'~'t'~-
CONTRACTOR: ~ " *~"~-CJ~
DATE INSPECTION REQUESTED: ~ ~ TIME INSPECTION REQUESTED: ~ r` ~ V O ~ PERMIT N0: _
`HYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASS FAILED
COMMENTS.
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:..
ELECTRICAI;; ^ ROUGH IN FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS FAILED
^ PARTIAL ^
COMMENTS:
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT FINAL ^ PARTIAL
COMMENTS:
FAILED
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN FINAL ^ WATER METER INSTALLED ^ PARTIAL PAS D FAILED
COM~NTS: ^
I/I UI;I;UYA1Vl:Y liKA1V'1'l~;ll
NOTES/REMARKS:
{.
CONDITIONAL OCCUPANCY GRANTED
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
j
.r~~°{ e
~^ CITY OF BLAIR
BUILDING~:INSPECTION REPORT
~ ~~
^ WASHINGTON COUNTY
LOCATION OF INSPECTION:
NAME OF OWNER: ~ ~~ ~ ~ ~~~
DATE INSPECTION REQUESTED: 2 ~ ~"
^ OTHER
1
S~r-.
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
CONTRACTOR: ~ ' `(~"`~~~a ~ r '~ e'~~
7
TIME INSPECTION REQUESTED:. ~ ' ~~ PERMIT N0: ~ `--' O" ~""'
TYPE OF INSPECTION REQ~IESTED: ^ 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
^ 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 PAS FAILED
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
~---
- , l C~
INSPE INSPECTION MADE: ~ /
°- ~ j ~~-° BUILDING INSPECTION REPORT
^ CITY OF BLAIR ^ WASHINGTON~ICOLLNTY /L~ . ~^ OTHER
LOCATION OF INSPECTION• ~/~ ~ `~/° / f
,e_
NAME OF OWNER: ~~ ~ CONTRACTOR:
~ f /
DATE INSPECTION REQUESTED: ~~~~ CJ~~ TIME INSPECTION REQUESTED: ~~ ~ 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
^ 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:
f r~
DATE OF INSPECTION MADE: ~ TIME: ~`
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
BUILDING INSPECTION REPORT
CITY OF BLAIR
^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION:
NAME OF OWNER: ~~" ~~ '" "•"' CONTRACTOR: ~~~~''f t~~S' "`~' """" ~"'~'
DATE INSPECTION REQUESTED: " ~ ~~ ` TIME INSPECTION REQUESTED: ~ ~1. ~ ~ ~ ~ PERMIT N0:
TYPE OF INSPECTION REQUESTED:
^ CONFERENCE ^ STATUS CHECK
ELECTRICAL ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS ~ FAILED
^ PARTIAL ~ ^
COMMENTS: .4.,~C~r-e~ /W-N~-~
MECHANICA ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASS FAILED
COMMENTS: .-
PLUMBING: ^ GROUNDWORK ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PAS FAILED
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
uv~Y~~1UK^~~ ~ ~ ~ - Gj w~-"DATE OF INSPECTION MADE: ~~ ' C~ i
FAXED OPPD~BURT REA-~ "" 7 ~ ~ / D 2 - TO CONNECT SERVICE: ON BY
~/
~~
TIME:
a. m
.,
CITY OF BLAIR
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION: ~' ~ ~ ~ ! L,
NAME OF OWNER: ~ '"„ CONTRACTOR: ~ " jC0"~''~'~-
DATE INSPECTION REQUESTED: ' ~ o ` d ~ U ~ TIME INSPECTION REQUESTED: ~ ~ ~ ~~
TYPE OF INSPECTION REQUESTED:
S 33-~IS3 5
PERMIT N0: ~ ` ~~
^ CONFERENCE ^ STATUS CHECK
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
,`
OF INSPECTION MADE: ~ c~ O~TIME: /~' "
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
i _ BUILDING INSPECTION REPORT
..
CITY OF BLAIR ^ WASHINGTON COUNTY ~ ^ OTHER
~ I~
LOCATION OF INSPECTION: Q j l1 N 'APT j ~ -
V1 l K.I~
NAME OF OWNER: ~C'~ V ~~~ CONTRACTOR: ~ ~ h'~ ~~ ~ i r" ~ S C~ ~%1 ~~ - y ~ JCj
DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED: ~ (/~ PERMIT N0:
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
DATE OF INSPECTION MADE: ~~ ~ ~~IME: O `,
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
• u
~p -. - ~.~ BUILDING INSPECTION REPORT
~ITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION: ~ ~ ~ ~ ~ ~ ~~
NAME OF OWNER: ' ~" ~~ ' 1.~ CONTRACTOR: ~~ • L~2
DATE INSPECTION REQUESTED : ~ ~ ~ ~ r ~ ~ TIME INSPECTION REQUESTED: ~ l
PERMTI'
N0: ~~~
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMIIVG ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^°
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE
^ PARTIAL
COMMENTS: PASSED
^ FAILED
^
ELECTRICAL: ^ ROUGH IN
^ PARTIAL
COMMENTS: ^ FINAL. ^PERMANENTSERVICE TEMPORARY SERVICE ^ PRECONNECT
`
~'w~ D~ ~~ PASSE
~
/`--' FAILED
^
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:
DATE OF INSPECTION MADE: ~ ~ ~~ TIME: ~LG~~l~'
FAXED OPPD~BURT REA fj~~~~' ~° TO CONNECT SERVICE: ON BY -
~:- ,, - -"
' BUILDING INSPECTION REPORT
CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
///LOCATION OF INSPECTION: ~ 1 ~ [ `" ~ ~ y~
NAME OF OWNER: _ ""'"'~"' ~ CONTRACTOR: ""~ ' "'"' ~'~"! "`'"~
DATE INSPECTION REQUESTED: 4 ~ I~. ~ °~ TIME INSPECTION REQUESTED: ~ +' ~ ~ 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 WATER SERVICE PASSE FAILED
^ PARTIAL ^
COMMENTS:
ELECTRICAL: ^ .ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED FAILED
^ RARTIAL ^ ^
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
` 1~
NOTES/REMARKS: ~~ ~~;;_,
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON By
CITY OF BI,t1Il~
p~
o~~se of
BUILDING PERMIT DEPOSIT AGREEMENT
A $200.00 refundable deposit is being collected at the time of your building permit
application for all permits $10,0000 and above. However, the City reserves the right
to not refund this deposit if any of the following conditions occur during .the
construction period: 1.) theft of water service by either the plumber, owner or general
contractor, 2) all required inspections have not been obtained (this includes drywall
prior to taping), 3) occupancy occurs prior to a final inspection, 4) all permits have
not been obtained, and 5) the project is completed without a final inspection being
done. If any or all of these situations occur during construction, you may forfeit your
deposit.
I, hereby agree to the above conditions, and understand that should any or all of the
above situations occur, the building permit deposit SHALL be forfeited or discounted
upon the discretion of the City of Blair, Building and Inspections Department.
Con actor/O er
Contractor/Owner
%C
City of Blair
/l~ /~
j
Date
218 South 16th Sheet • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel.net
CITY OF BI,L~IR
~Oro~'Se f Q J~~~
0
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/Occupant
~- '~G~ ~G
City of Blair
Contr for
Date
/_~
.._.
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cilyofblalr@huntel.net ,~~°~~,
='
~S~
hl
1
,d
~: ~~L
~ ;~
~.
ct ~ ~
,
~ .7 4,.i ~
~
...
~,v .,,
~~
•
~
.
~
.
~ a
. ,o
--~"
"
'"'p
"°„~
. ~,
_S".
~'
'.
s
',
r.r ~-~
~ ~ "' `ft`