BP11754City of Blair Building Permit Detail
Permit #: 11754 Issued: 10/14/2004 Type: Roofing permits -All types
Completed: 12/28/2004 Valuation: 43000
Location: 1215 1225 1235 1255 1265 & 1285 N. 10th Street
Owner: Northview Point LLC Permit Fee: 15
Address: 4852 S. 133rd Street Issue Fee:
Omaha, NE 68137
Phone:
Section: Township: Range:
Subdivision: Lot:
Tear off one layer asphalt; replacing with asphalt class "A" fiberglass
Contractors
Landmark Enterprises
General Contractor
Remarks
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
12!28/2004 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 1 17 5 4
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: ~ f -
Issue Date: ~ b ~ ~ ~~ Type: ~ r< <1 ~/)
JOB ADDRESS
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LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
OWNER ~ 1
2, (~ ~~ ~C_ / ~ , MAI ADDRESS
)L(/~ ~_ Zlp HOME PHONE
WORKICELL PHONE
COhITRACTOR
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4. Class of Work: i
NEW 0 ADDITION Q REMODEL ~ OTHER Q FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work: R~- --k~v~~ ~ ~
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6. Valuation of Work: $ 43 (~0~ -Z~ Total Sq. Footage pncluafng Basement ana Garage): Total Finished Area:
Floodway Q Yes Q No Dev. Permit
7. Floodplain: Fringe Q Yes Q No BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: Q Yes l7 No
10. Special Use Permit Required: Q Yes ^ 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 furtheragree 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. l understand thatthis~~ermit is void if work is not commenced within
180 davs~is not completed within,2'Gears of date of issue.
SIGNATURE OF
Comment:
POUNDS PRIG: 61etr, NE
DATE
Q Site Plan Attached ; ~Q~ pmplete Plans Attached
Approximate Completion Date / I `f
Inspections Required and Fees
ili i
Sewer _
Septic _
Buildin
Footings
Framing
EI c ric I
Rough-in
Final
Temporary Service
Mechanical _
Rough-in
Final
Plumbin
Ground Work
Rough-in
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: n - , ~ /)
Rev.8/96
Water Service
Remote
Stop Box Card
Drywall
PRIOR TO TAPING)
Final
Fixtures
Permanent Service
A\C ,
BUILDING INSPECTION REPORT
L/J CTI'Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
~ LOCATION OF INSPECTION ~~/..~:~ - `f``~`` ~ ~ `~'~'~ `' `~.~-'`~'?'~'~ - i ~~r~° /~~,j !~/~ /O 'T~~J'~J`6
NAME OF OWNER/ ~ ~~~•' / ~~1'!~ / <~ =%"~~ ~~ ~ ~/ CONTRACTOR ~ f~_~'I ~..1-'YI L~~°'y% ~? ~ ~ v~'~
f/'%ir
.DATE INSPECTION REQUESTED• ~'~~~~=`i~~~~~ ~ ~ TIME INSPECTION REQUESTED: ~ ~ PERMIT NO• l ~`-1
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^
COMMENTS: FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL
~
~G~ PASS FAILED
^
UTILTTIES: ^
^
COMMENTS: SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE
PARTIAL PASSED
^ FAILED
^
ELECTRICAL: ^
^
COMMENTS: ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT
PARTIAL PASSED FAILED
^ ^
MECHANICAL: ^
COMMENTS: ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED
^ FAILED
^
PLUMBING: ^
^
COMMENTS: GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL
PRESSURE TEST PASSED
^ FAILED
^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS•
/ `I / ,
DATE OF INSPECTION MADE: C T ` ~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON
CITY OF BI,~~II~
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 ahd 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.
i
{
caner/Occupant
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City of Blair
Contractor
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Date
~-
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cifyofblair@ci.blair.ne,us ~~~•~'~•"'
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