BP10362City o~ Blair Building Permit Detail
Permit #: 10362 Issued: 6/17/2004
Completed: 10/24/2004
Location: 1245 Kristen Cir
Owner: Bill Nielsen
Address: 1245 Kristen Cir
Blair, NE 68008
Phone: (402) 426-2366
Section: Township: Range:
Subdivision: Lot:
tear down one layer to decking and put on asphalt shingles
Contractors
McKinnis Roofing & Sheet Metal
General Contractor
Remarks
Type: Roofing permits -All types
Valuation: 4000
Pennit Fee: 15
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
10/2M2004 KAfi Final Inspection of Project Pass
yN BUILDING PERMIT APPLICATION
i~ ,~~ Jurisdiction of Clty of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008 10 3 6 2
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: ~~
Issue Date: i Type:
JOB ADDRESS !)
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LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
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2. 1 ~U~~ ~~~~r
J MAJLADD~SS G ~ ZIP
III` HOME PHONE ~i1,t c~~~~
WORK/CELL PHONE ` ~j(,~
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MAI~ADD~ESS ~~ ZIP ) ~
yyORKICEOL PHONE ~~~~~- J
4. Class of Work: Q NEW Q ADDITION O REMODEL OTHER O FINISHED BASEMENT O UNFINISHED BASEMENT
5. Describe Work: Q~/' ~~ l l ~ -~ ~• Q~
6. Valuation of Work: $ ~' Total Sq. Footage (IRDIudiRg Basement anli Garage): Total Finished Area:
Floodway ^ Yes
7. Floodplain: Fringe ^ Yes ^ No
^ No Dev. Permit
BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes Q No
10. Special Use Permit Required: Q Yes Q No
11. Variance Required: Q Yes Q No
12. Minimum Setbacks: Front Side Rear
13. Sidewalk Required: O 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
State of Nebraska. I understand that this permit is void if work is not commenced within
\80 ays or is not completed within 2 years of date of issue.
II ,
OF
Comment:
Q Site Plan Attached ~ f QCgmp~e Plans Attached
Approximate Completion Date 1' c /~
Inspections Required and Fees
Utilities
Sewer
Septic
Buildin
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 (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: I°~
Rev. 8196
POUNDS PRTG.-Blair, NE
BUILDING INSl'ECTIONREPORT
CITY OF BLAIR ^ WASHIN
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LOCATION OF INSPECTION: _ f
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7 i ~ /S / [
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NAM} OF OWNER: ~~ /~ /V /E`_' l~~'/% CONTRACTOR: ~` ~~'~~~~f
DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED: ~ / 7 PERMIT N0: l~~ ~-°~
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^STATUSCHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL P 'SED FAILED
COMMENTS: ~0^ ~j0'~
^ ' 1
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED'
^ PARTIAL . _ ^ ^ 1
COMMENTS:
ELECTRICAL:. ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT P-ASSED FAILED
^ PARTIAL ^
COMMENTS:
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED;: FAILED'
x .4 ^ ^ ; ~
COMMENTS:
;~
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ yFINAL } ^ WATER 1vIETER INSTALLED ^ PARTIAL PASSED FAILED ~
.j ^ ^ 1
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED ~ ~ ~~
1
NOTES/REMARKS:
FAXED OPPD~BURT REA
TQ CONNECT SERVICE: ON BY
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CPI's' O~ BL SII~
ROOF[NG PERM[T SUPPORT[NG DOCUMENTS
This supporting document includes information dealing with particular code
requirements and/or roofing permit requirements. It in no way includes f~LL particular
code items. Also, if is your responsibility fo know fhe 20D3 internat[ona[ Bui[d'mQ
Code requirements that apply to your project. Please understand this document is only
designed ahd distributed to aid you fn 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 Phis building permif documentation on my
own behalf assuming full responsibility as the owner/contracfor for fhis pfojeet.
Owner/Occupant
City of Blair
Con a for
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218South I bth Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail ciryofblair@ci.blair.ne.us •~:n.m