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BP10176City of Blair Building Permit Detail Permit #: 10176 Issued: 5/10/2004 Type: Roofing permits -All types Completed: 6/16/2004 Valuation: 6921 Location: 1840 South Street Owner: Nebraska-Iowa Supply Permit Fee: 15 Address: 1840 South Street Issue Fee: Deposit Amt.: Blair, NE 68008 Receipt #: Phone: Section: Township: Range: Subdivision: Lot: Tearing off old layers and replacing with asphalt shingles Contractors Frank Gabby Siding & Windows General Contractor Remarks Block: Permit # Issued Inspections Date By 6/16/2004 DEM Final Inspection of Project Pass ,_ ' BUILDING PERMIT APPLICATION ~~ ~^ U~ Jurisdiction of City of Blair, Nebraska Permit Fee: ,~ 218 South 16th Street Issuance Fee: Blair, Nebraska 68008 1017 6 Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit Deposit Receipt #: ~- Issue Date: SA `y U ~ Type: (}i~~ JOB ADDRESS ~ ! ~ ,,~~,nf Lt/`" LEGAL 1 . DESCR. ^ SEE ATTACHED SHEET OWNER 2, ,.Q~ . '~ . MAIL ADDRESS ZIP r HOME PHONE WORKICELL PHONE 3 C~TRACTOFn -3 u 1~ 1' ~ /- n n ~+ ~ ~} MAIL ADDRESS 7 O ZIP~~~r' yyORKICEOLLPHONE ~'~~~/~~~Jd' MODEL ^ OTHER rk: ^ NEW ^ ADDITION ^ RE s s f W o 4. Cla o ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT 5. Describe Work: ~ ~ C~t~ W g~ 6. Valuation of Work: $ G ~ ~: ~ ' Total S . Foots a Includin Basement andGara e q g 1 g g ): Total Finished Area: Floodway ^ Yes ^ No 7. Floodplain: Fringe Q Yes ^ 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 13. Sidewalk Required: ^ Yes Side Rear ^ 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 permitapplication 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 days or is not complet ithin 2 years of date of issue. ~S ~~~~~ SIGNATURE OF OWNERICONTRACTOR DATE Comment: ^ Site Plan Attached ^ Complete Plans Attached Approximate Completion Date ~ `~ ~ ~ UY Inspections Required and Fees Utilltle~ - Sewer _ Septic Buildin Footings . Framing Electrical Rough-in Final Temporary Service Mechanical Rough-in _ Final Water Service Remote Stop Box Card Drywall (PRIOR TO TAPING) Final Fixtures Permanent Service ABC Final Plumbing _ Ground Work Rough-in _ WHEN PROPERLY VALIDATED Approved By: n _ THIS SPACE) THIS IS YOUR PERMIT I I ~' ` `l3~_/__ Rev. 6/96 POUNDS PRTG: Blair, NE BUILDING INSPECTION REPORT ^ CI~'I~ OF BLAIR ^ W/AS~HINGTON COUNTY ^ OTHER LOCATION OF INSPECTTON: /~7 v ~l ~~~ ~~~~ NAME OF OWNER: ~~~~~~~~f~ " ~~~~ ~~/-~X~NTRACTOR: DATE INSPECTION REQUESTED: ~ ~~ ~ '~ TIME INSPECTION REQUESTED: ~~~~ .PERMIT N0: ~~~~~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE STATUS CHECK BUILDING: ^ FOOTING ^ DECKFOOTING ^ FRAMING ^ DRYWALL F/IN~AL ^ PARTIAL PASS FAILED COMMENTS: ~~ /~©O F 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: DATE OF INSPECTION MADE: ,~o~ ~~ TIME: FAXED OPPDIBURT REA TO CONNECT SERVICE: ON BY CITY OF BZAII~ ~~ rod jse of ROOFING PERMIT SUPPORTING DOCUMENT T his supporting .document includes information dealing with particular code requirements and/or roofing permit requirements. It in no way includes ALL particular code items. Also,. it is your responsibility to know the 2000 International Building Code .re~>airements .that .apply to your .project: Please understand this document is only destgned and distributed to aid you in your roofing permit process. A copy of the International Building Code. is available for your, use at-the Blai1-Public Library. l have read. the above discloser-e and accept this building permit doEUmentation an my own beflaif assuming fu11 responsibility as the ownerLcontractorfnr this project. QwnerLQccupant City- of .Blair `~~~ Contractor Date 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cilyofblair@huntel.net