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BP10323City of Blair Building Permit Detail Permit #: 10323 Issued: 6/15/2004 Type: Roofing permits -All types Completed: 7/6/2004 Valuation: 9490 Location: 564 S 17th Street Owner: Homer Nielson Permit Fee: 15 Address: 564 S 17th Street Issue Fee: Deposit Amt.: Blair, NE 68008 Receipt #: Phone: (402) 426-3271 Section: Township: Range: Subdivision: Lot: Block: tearing off one layer down to decking and replacing with 30 year asphalt shingles and gutters Contractors American Roofing of Iowa General Contractor Permit # Issued Remarks Inspections Date By 7/6!2004 DEM Final Inspection of Project Pass .~~ BUILDING PERMIT APPLICATION © Jurisdiction of City of Blair, Nebraska Permit Fee: 218 South 16th Street Issuance Fee: Blair, Nebraska 68008 10 3 2 3 Receipt #; (402) 426-4191 • Fax (402) 426-4195 Permit Deposit Receipt #: Issue Date: Type: JOB ADDRESS ~ ~ ~~ LEGAL 1 . DESCR. ^ SEE ATTACHED SHEET OWNER 2, ~ e ' ~ I~0 ~ M I ADD ESS ~ HOME PHONE ~j~ (~ WORK/CELL PHONE ' ~~ CONT T R ~~ ~~ ^~ S. U l ADDRESS I ~ Vfjl ZIP ` FjBME PHONE ~~- ~(r~ORK/CELL PHONE 4. Class of Work: Q NEW ^ ADDI ON Q REMODEL .OTHER ^ FINISHED BASEMENT Q UNFINISHED BASEMENT 5. Describe Work: ~ ~~`/' ®r.~ ~ ~ ~~ ~ C;~~ (~' ~( (~ ~ l 6. Valuation of Work: $ ~O, Total Sq. Footage (IRCIudiRg Basement aRd Garages: Total Finished Area: Floodway Q Yes ^ No 7. FIOOdplaln: Fringe Q Yes ^ No Dev. Permit BFE Elev. Cert. 8. Current Zoning, 9. State Fire Marshall Required: 0 Yes Q No 10. Special Use Permit Required: Q Yes Q No 11. Variance Required: Q Yes ^ No 12. Minimum Setbacks: Front 13. Sidewalk Required: Q Yes Side Rear 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 bythis permit application shall not be commenced until I have received a copy ofthis application form signed bythe Building Inspector. I herebyagree to perform the proposed work in accordance with the specifications set forth abov and in accordance with th codes/ordinances of the City of Blair and the State a raska.lunderstandthat permitisvoidifworkisnotcommencedwithin 180 ays r is not completed withi ars of date of issue. SIGNATURE OF NER/CONTRACTOR DATE Comment: Q Site Plan Attached ~ ,~IC,gr~~lete Plans Attached Approximate Completion Date l~l I ~''~ ~ (~ Inspections Required and Fees Utilitie Sewer Water Service Septic Remote Stop Box Card Building Footings Drywall (PRIOR TO TAPING) Framing Final E ec rical Rough-in Fixtures Final Permanent Service Temporary Service M ni Rough-in _ Final Plumbing . Ground Work Rough-in _ Final WHEN PROPERLY VALIDATED Approved By: /~ / ~ A1C THIS SPACE) THIS IS YOUR PERMIT POUNDS PRIG: Blair. NE , ` ~ Rev. 6/96 CTI'Y OF BLAIR BUILDING INSPECTION REPORT ^ WASHINGTON COUNTY ^ OTHER ~ " ~ ~ ~~ LOCATION OF INSPECTION: 7 ~ - ! ~ ~ ~ ~ ~ ~"'"" a' NAMI OF OWNER: ' CONTRACTOR: I ~`~ DATE INSPECTION REQUESTED: ~ ~ TIME INSPECTION REQUESTED: ~ ~ PERMIT N0: ~ ~ ~ ~~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK: BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINA L ^ PARTIAL PASSE FAILED / ~ COMMENTS: /6- 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 ~ FAIi.ED ^ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: Tom:. ,`'~ ~ 1 FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY ~ ~~ ~' ~~-- .~ -__ _= CITY OF BU~~II~ - ~~~ aro~~se Of avd\\ ROOFING PERMIT SUPPORTfNG DOCUMENTS This supporting document includes information dealing with particular code requirements and/or roofng permit requirements. ft in no way includes f~LL particular code items. Also, it is your responsibility to know the 2QQ3 fnternafional Buiidin~q Code requirements that apply to your project. Please understand this document is only designed anddistributed to aid you in your rooftng 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 cvy~ behalf assuming full responsibility as the owner/contractor for Phis project. 1 ~~ - ~ , rn ~° lQ 1 C~ l~I c~ , ) ~ . ant ~ Contractor City of Blair Date .,. ~- 218South ] 6th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cityofblair@ci.blair.ne.us e::•'n.~,.