M1134City of Blair Building Permit Detail
Permit #: M1134 Issued: 11/3/2004 Type: Mechanical Miscellaneous
Completed: 11/4/2004 Valuation:
Location: 870 N. 16th Street
Owner: Jeff Nelsen Permit Fee: 10
Address: 870 N. 16th Street Issue Fee: 15
Deposit Amt.:
Blair, NE 68008 Receipt #:
Phone:
Section: Township: Range:
Subdivision: Lot:
Repalce A/C - 2.5 ton
Contractors
Washington County Heating & A/C Inc. General Contractor
Remarks
Inspections Date By
11/4/2004 DEM Final Inspection of Project
Block:
Permit # Issued
Pass
.~ ~~~
~ MECHANICAL PERMI
T APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 113 4
(402) 426-4191
` ~~(
Application Date: I l ~ ~ ~ ~ 1
Permit Fee: $
2~ Y
JOB ADDRESS ~ ^ /~ ~ ~ ~~ ~~., ~,
, )~
WNE
MAIL ADDRESS ZIP PHONE
1. P ~ o~~.i~~n ~~ ~ ~ ~~ n-~ S~
C NTR CTOR MAIL ADDRESS PHONE LICENSE NO.
2~~ ~n ~~ ~ ~ I ~ ~ S~cL~ ~~-- ~~~Q >a -~~-- 5~~ - ~-~~~
3• Class of Work: O COMMERCIAL ~ ~tESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR REPLACEMENT
4• Describe Work: r,~ ' ~~ I ~_~
Central A/C ~~°~ Tons MECHANICAL PERMIT FEES
Furnace BTU/H Forced Air/Heat Pump Systems -Per Unit
Commercial/Residential (New) .................................................... $25.00
# of Units 'vC
Air-Conditioner Unit -Per Unit
Furnace Commercial/Residential (New) .................................................... $10.00
Forced Air Systems/Air Conditioner L ~ ` U~
( c~ l~ ~ Unit Replacement Per Unit Commercial/Residential ................... $10.00
Completion Date: /
Refrigeration Units/Coolers/Lines/Compressor -
Per Unit Commercial (New or Replacement) ...... ..................... $10.00
Comments:
Appliance Vent/Fans ............................... $10.00
Boiler .......................................................$15.00
Duct System ............................................ $10.00
Gas/Air Outlets .................. x $2.00
NOTICE Radiant Heat Systems ............................$25.00
I hereby certify that I have read and examined this
li
i
d k
app
cat
on an
now the same to be true and correct. All
provisions of laws and ordinances governing this type of
Modular Home
$15
00
work will be complied with whether specified herein or not. .........................................
.
Th
ti
f
it d
t
i
e gran
ng o
a perm
oes no
presume to g
ve authority
to violate or cancel the provisions of any orb r state or local
' ~ ~ '
~°~
law regul onstruct
n or the jper ormance of Permit Issuance Fee ............................... $15.00
const
xr Ion
r
.
TOTAL ~ ~~~
~
SIGNATURE OF CONTRACTOR 0 AUTHORIZED AGENT
Current License on File ~J Yes O No O NA
DATE /
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By: ~l ,~
POUNDS PRTG.~Blair, NE Rev. 4/98
~~ = BUILDING INSPECTION REPORT
~CTI'Y ~F BLAIR ^ WASHINGTON COUNTY ^ OTHER /
LOCATION OF INSPECTdON~• ~ (J f \, ' ~(_],~
NAME OF OWNER• \~~~~-F~'~ CONTRACTOR• 1V ~ C~ 1 7 ,'P'1
DATE INSPECTION REQUESTED (1't`~ t ~ ~ TIME INSPECTION REQUESTED_ ~ ~ ~ PERMIT NO•
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASS FAILED
l ~/i / ^
COMMENTS: `•'~
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 PASS FAILED
COMMENTS: .r- !
~- ~ l C ~ ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
^ PRESSURE TEST ^ ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
/ ~/LlK1C U ' fig `~ - -~/ DATE OF
FAXED OPPD~BURT REA TO CONNECT SERVICE:. ON
T ~'D
BY