BP10572City of Blair Building Permit Detail
Permit #: 10572 Issued: 6/25/2004
Completed: 8/11/2004
Location: 2346 Nebraska
Owner: Elsie Nielsen
Address: 2346 Nebraska
Type: Roofing permits -All types
Valuation: 4300
Blair, NE 68008
Phone: 426-2141
Section: Township: Range:
Subdivision: Lot:
Tearing off one layer and replacing with asphalt
Contractors
Lastime Roofing * Guttering * Awning
Remarks
General Contractor
Permit Fee: 15
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
8/11/2004 DEM Final Inspection of Project Pass
J
~' I~UILDING PERMIT APPLICATI®N
Jurisdiction of City of Blair, Nebraska
Permit Fee: ~ 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008 10 5 7 2
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: O '
Issue Date: ~ . Type:
JOB ADDRESS :^~
(•/!•1 ,ry
`IC/~ `~.
Y
LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
OWNER
2. ` r MAI D ZIP WORKICEOLL PHONE
CONTRA 0
3,
~/`-' I t~ L DRES
6 ZIP
+ HOME PHONE ,
WORK/CELL PHONE
4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5, Describe Work: ~~ ~ ~ ~ ~ d a
6, Valuation of Work: $ ~ O Total Sq. Footage (Including Basement and Garage): Total Finished Area:
Floodway O Yes Q No
7. Floodplain: Fringe ^ 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 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 thatthis permit is void if work is not commenced within
180 days or is not comg~ted within 2 years of date of issue. ~ ~
Comment:
OF
^ Site Plan Attached ~ I ~~~ ~nplete Plans Attached
Approximate Completion Date .I
Inspections Required and Fees
Utilities
Sewer
Septic
Buildin
Footings
Framing
Electrical
Rough-in
Final
Temporary Service
Mechanical
Rough-in
Final
Plumbin
Ground Work
Rough-in
WHEN PROPERLY VALI
Water Service
Remote
Stop Box Card _
Drywall
(PRIOR TO TAPING)
Final
Fixtures
Permanent Service
ABC
Final
Approved By: / ~ / t
(IN THIS SPACE) THIS IS YOUR PERMIT
POUNDS PRTG: Blair, NE ~ v Rev. B/96
~ITY OF BLAIR
///LOCATION OF INSPECTION:
NAMR OF OWNER:
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY
~ ~ ~ ~o
^ OT R
N `
CONTRACTOR:
DATE INSPECTION REQUESTED: ~ A ~ f TIME WSPECTION REQUESTED: ~ ~ PERMIT N0:
_ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE [
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL
COMMENTS
1~~ 7~
STATUS CHECK
PA/F- FAILED
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: - ~ ^ 3
'PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
COMMENTS:- ^ ^
OCCUPANCY. GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES%REMARKS:
DATE OF INSPECTION MADE:
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON
~f
BY
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TIME:~r `-~~
CITY OF' BI,~~IR
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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
City of Blair
ontra for
s
Da e
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cityofblair@ci.blair,ne.us