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BP10346City of Blair Building Permit Detail Permit #: 10346 Issued: 6/16/2004 Type: Roofing permits -All types Completed: 7/12/2004 Valuation: 7500 Location: 2029 Jackson Street Owner: Richard Nordstrom Permit Fee: 15 Address: 2029 Jackson Street Issue Fee: Deposit Amt.: Blair, NE 68008 Receipt #: Phone: (402) 426-9809 Section: Township: Range: Subdivision: Lot: Block: tearing off three layers and replacing with asphalt also redecking ;replacing gutters Contractors Nebraska Roofing Co. General Contractor Permit # Issued Remarks Inspections Date By 7/12/2004 DEM Final Inspection of Project Pass ~~ ~~ J BUILDING PERMIT APPLICATION S~~- Jurisdiction of City of Blair, Nebraska Permit Fee: 218 South 16th Street Issuance Fee: Blair, Nebraska 68008 10 3 4 6 Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit Deposit Receipt #: Issue Date: ~2 ~~' ~~ y Type: r JOB ADDRESS ~ f` ~ ~ ~ l! LEGAL 1 . DESCR. ^ SEE ATTACHED SHEET 2 0 ER ~ ~ MAIL ADDRESS Zip ~ /„~~ ~ HOME PHONE ~~ I ^~~ ti d WORKICELLPHONE b ~~Q~^ ,, - / .3. C~R,~NO~Y-l.!{ ~ e r- C~ ~ j~ Q' `-'D . l D ~ AIL ADD o` O.~ ~' V M~Q>:!'~. ~{/ G~j' e^°~ / ~P ~ r U ~ WORK/CEOL PHONE 3 7 lM" I `G / 4. Class of Work: Q NEW Q ADDITION Q RREMODEL O OTHER O FINISHED BASEMENT ~ UNFINISHED BASEMENT Desc 5 . ribe Work: _ J _ ~ ~ n ~ 1x/1-lT ^ cv[•~ 0 6. Valuation of Work: $ ~SU~ Total Sq. Footage (IRCludlrtg Basement and Garage): Total Finished Area: Floodway Q Yes Q No 7. FIOOdplaln: Fringe Q Yes Q No Dev. Permit BFE Elev. Cert. 8. Current Zoning: 9. State Fire Marshall Required: Q Yes 10. Special Use Permit Required: Q Yes 11. Variance Required: Q Yes Q No Q No Q No 12. Minimum Setbacks: Front Side Rear 13. Sidewalk Required: Q 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 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 of this 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. I understand thatthis permit is void if work is not commenced within 180 days or is not completed within 2 years of dat of issue. SIGNATURE OF Comment: Q Site Plan Attached Complete Plans Attached Approximate Completion Date ~n' O "C~~ Inspections Required and Fees Utilities Sewer _ Septic _ Buil in Footings Framing Water Service Remote Stop Box Card EI c ric I Rough-in Final Temporary Service Mechanical Rough-in _ Final Drywall (PRIOR TO TAPING) Final Fixtures Permanent Service A1C Plumbing Ground Work Rough-in _ Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Approved By: n ~ POUNDS PRTG: Blair, NE ~ Rev. BKJ6 ., BUILDING INSPECTION REPORT - -- CITY OF BLAIR \~~ 11 ^ WASHINGTON COUNTY ^ OTHER LOCATION OF INSPECTION: ~ U ~ S NAME OF OWNER; CONTRACTOR:_ DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED: ~ / U ~ j~v PERMIT NO: TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOO'I;ING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINS ^ PARTIAL PASS FAILED.. COMMENTS: ~I ~ ^ UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE ^ PARTIAL PASSED FAILED COMMENTS: - ^ ^ ELECTRICAL ^ : . ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT ^ PARTIAL PASSED FAILED COMMENTS: ^ MECHANICAL ^ R : OUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED COMMENTS: ^ .°f ^ PLUMBING ^ : GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL - PASSED FAILED COMMENTS: ^ ^ ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: TIME: ~i'~-%~ FAXED OPPD\BURT REA TO CONNECT SERVICE:. ON BY CI1Y OF BLI~IR ~~~~ ~~ ?~ promise of~ qv~\~ ROOFING PERMIT SUPPORTING DOCUMENTS This 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 2003 International Building Code requirements that apply to your project. Please understand this document is only designed and distributed to aid you in your roofing 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. Owner/Occupant Contractor City of Blair ~ o Da e 1=1 218 South 16th Street • Blalr, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail ciiyofblair@ci.blalr.ne,us ~~ ~ ~"'