BP10041City of Blair Building Permit Detail
Permit #: 10041 Issued: 10/13/2003
Completed: 11 /7/2003
Location: 1453 Grant Street
Owner: Sandra Paulsen
Address: 1453 Grant Street
Blair, NE 68008
Phone: 402 533 2572
Section: Township: Range:
Subdivision: Lot:
Tear down to decking and install on asphalt shingles
Contractors
SELF
General Contractor
Remarks
Type: Roofing permits -All types
Valuation: 2000
Permit Fee: 15
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
11/7/2003 DEM Final Inspection of Project Pass
~~ BUILDING PERMIT APP
LIGATION
`~ L Jurisdiction of City of Blair, Nebraska
Permit Fee: .218 South 16th Street 10 0 41
Issuance Fee: Blair, Nebraska 68008
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #:
Issue Date: ~~ ~ I ~~ Type:.. I ~-~
JOB ADDRESS /~
l.J (~~
LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
NER ~~
2 MAILiDDRrEJS3 ~ ~
~`[`[ Zlp OM HONE ~~~ ,~~~
WORK/CELL PHONE
3 CONTRAiT~I
L~~CD_ '1L~ MAIL ADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL ~Q'OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work: '~~~ ~ ~' ~ ,~ ~- ~~ ~ ~~~
l~(JJ
6. Valuation of Work: $ ~ r~~~ Total Sq. Footage Qncl~aing Basement ana Garage): Total Finished Area:
Floodway Q Yes Q No
7. Floodplain: Fringe Q Yes Q No Dev. Permit
BFE Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes ^ No
10. Special Use Permit Required: ^ Yes ^ No
11. Variance Required: ^ Yes ^ 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 further agree that construction covered by this permit application shall not be
commenced until I have received a copy ofthis 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 ifwork is not commenced within
180 days or is t completed withi ears of date of issue.
SIN URE OF OWNER/CONTRACTOR DATE
Comment:
^ Site Plan Attached l l ` ~~omple~~te Plans Attached
Approximate Completion Date C~~
Inspections Required and Fees
Utilities
Sewer _
Septic _
Building
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical
Rough-in
Final
Plumbing .
Ground Work
Rough-in _
Water Service
Remote
Stop Box Card
Drywall
(PRIOR TO TAPING)
Final
Fixtures
Permanent Service
A\C
Final
WHEN PROPERLY VALIDATED
Approved By: ~ l
THIS IS YOUR PERMIT
POUNDS PRTG.~Blair, NE ~~ Rev.8/96
BUILDING INSPECTION REPORT
CITY OF BLAIR ^ WASHWGTON COUN~jT,Y/~ ^ OTHER
LOCATION OF INSPECTION: ~ ~ 1 ,
NAMI OF OWNER: V"' '~tY 5 '~ `°-` 1 CONTRACTOR:
DATE INSPECTION REQUESTED: ~ ~ TIME INSPECTION REQUESTED:
TYPE OF INSPECTION REQUESTED:
BUILDING: ^
COMMENTS:
^ DECK FOOTING ^ FRAMIIVG ^ DRYWALL
~~ ' 1 PERMTI' N0: o~
^ CONFERENCE ^STATUSCHECK
FINAL ^ PARTIAL PASSE AILED
UTILTI'IES: ^ 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: ^ ~ k ., ,.
P
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
TIME: ~ • /~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
CITY OF BI,~IR
'br~_
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.
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.
ner/Occupant
City of Blair
Contractor
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cifyofblalr@huntel,net m