M1141r
City of Blair Building Permit Detail
Permit #: M1141 Issued: 11/9/2004
Completed: 11 /11 /2004
Location: 240 Arthur St
Owner: Maria Nizidlek
Address: 240 Arthur St
Type: Mechanical Miscellaneous
Valuation:
Blair, NE 68008
Phone: 426 9778
Section: Township: Range:
Subdivision: Lot:
Put in a 2 ton heat pump
Contractors
Washington County Heating & A/C Inc. General Contractor
Remarks
Inspections Date By
11/11/2004 DEM Mechanical Furnace
11/11/2004 DEM Mechanical Final
Permit Fee: 10
Issue Fee: 15
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Pass
Pass
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MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 114
(402) 426-4191
Application Date: U~ J~ ~~ l
Permit Fee: $ ~~ ' ~~
JOB ADDRESS ~ , I T \ '
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'~" I
1 OWNER ~ ~~ I \ ~ ~~ MAIL
ADDRESS
~^ Ir\ ~ 1~i ~ ZIP PHONE
2 CONTRACTOR(\ (~ MAIL ADDRESS PHONE LICENSE NO.
~~/UI`/~ `-~ .
3• Class of Work: O COMMERCIAL RESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR REPLACEMENT
4. Describe Work: a ~ ~ ~
Central A~/C ~~~r ~' Tons MECHANICAL PERMIT FEES
Furnace BTU/H
# of Units '°`/C Forced Air/Heat Pump Systems -Per Unit
Commercial/Residential (New) .................................................... $25.00
Air-Conditioner Unit -Per Unit
Furnace
Completion Date: ~~ ~` ~ I J~ y Commercial/Residential (New) .................................................... $1 .00
Forced Air Systems/Air Conditioner ~~-
Unit Replacement Per Unit Commercial/Residential ................... $10.00
Refrigeration Units/Coolers/Lines/Compressor -
Comments: Per Unit Commercial (New or Replacement) ...... ..................... $10.00
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
a
lic
ti
d k
th
t
b
pp
a
on an
now
e same
o
e true and correct. All
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
Modular Home ......................................... $15.00
The
rantin
of a
ermit d
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t
i
h
i
g
g
p
oes no
presume
o g
ve aut
or
ty
to violate or cancel the provisions of any other state orlocal
law regufa#+r3g truction or the perfo mance of
construction / '-
Permit Issuance Fee ............................... $15.00 /~~
.
J
C
TOTAL a~
S NATURE OF CON R HORIZED AGENT
Current License on File ~es O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By: / ~J , f
POUNDS PRTG.-Blair, NE Rev. 4l9B
BUILDING INSPECTION REPORT
^ CTI'Y OF BLAIR ^ WASHINGTON COUNTY
^
OTHER
LOCATION OF INSPECTION: l/ ~,,•~-~
B
~ r ~ ~~f' ""r"`te'
NAME OF OWNER• CONTRACTOR: W wtf~ • `'" u""•^1,
DATE INSPECTION REQUESTED• ' ~ ~ ~ TIME INSPECTION REQUESTED• ~ 1' ~ PERMIT NO• ~ ~ I ~'
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING:' ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED
^ ^
COMMENTS:
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
n PARTTAT_ n n
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 D FAILED
COMMENTS: ~ ~-tG~'_ ..,_~~~
^
PLUMBING: ^ GROUNDWO
K ^
R ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
- ^ t
~
PRESSURE'1~ST ^ ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
DATE OF INSPEC'~TON
FAXED OPPD~BURT REA TO CONNECT SERVICE: