P1101City Cf Blair wilding Permit 9etail
Permit #: P1101 Issued: 7/6/2004 Type: Plumbing Miscellaneous
Completed: 7l6/~004 Valuation:
Location: 1454 Nebraska Street
Qwner: Larry Nollen Permit Fee: 10
Address: 1454 Nebraska Street Issue Fee: 15
Deposit Amt.:
Blair, NE 68008 Receipt #:
Phone:
Section: Township:
Subdivision:
Replacing sewer lines.
Contractors
Henton Trenching, Inc.
Remarks
Range:
Lot:
Genera! Contractor
Block:
Permit # Issued
Inspections Date By
7/6/2004 DEM Plumbing Final Pass
7/6!2004 DEM Sewer Lines Pass
~~ ..
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 1101
Fax (402) 426-4195 P
(402) 426-4191
Application Date: ~ ` ~ ~~
Permit Fee: $ s `W
JOB ADDRESS I 1 , ~ ~ ^ ,
/ V
1 . OWNE~ ' A MAIL ADDRESS
,
~. ZIP PHONE
MAIL ADDRESS
rL C RACT~ ~
' PHONE LICENSE NO.
3• Class of Work: O COMMERCIAL RESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR REPLACEMENT
4• Describe Work: ,~,~
Comments: PLUMBING PERMIT FEES
Modular Home ...................... $15.00
Type of Fixture No.
Kitchen .................................. $8.00 x
Bath ....................................... $8.00 x
Rough-In Bath ....................... $4.00 x
Slop SinWLaundry Tray ......... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Drinking Fountain .................. $3.00 x
Water Service ........................ $10.00
NOTICE Sewer
.................................... $10.00 ~ U ' UV
I hereby certify that I have read and examined this Groundwork ........................... $10.00
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of Septic Tank & Laterals .......... $10.00
work will be complied with whether specified herein or not.
The granting of a permit does not presume to give authority Lawn Sprinkler System .......,. $10.00
to violate or cancel the provisions of any other state or local Sprinkler System ................... $30.00
law regulating constru tion or the performance of (Commercial)
construction.
Gas/Water Piping System
(Commercial) ............................ $30.00
Permit Issuance Fee $15.00 ~~^V w
SIGNA UR F CONTRACTOR 0 AUTHORIZED AGENT ~
7 S '
.~ ~ ~ _ Gy TOTAL o
DATE Current License on File Yes O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG.~Blair, NE Rev. M98
BUILDING INSPECTION. REPORT
CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION: O ~ ~ `I r ' - ..
NAMI OF OWNER: ~ ~/ ~"^' CONTRACTOR: ~t~~l-•
DATE INSPECTION REQUESTED: ~ .. ~ TIME INSPECTION REQUESTED: PERMTI' N0: ~ / / U
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL `' ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
UTILITIESc ^ SEWER TAP SEWER ^ IEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSE 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: ^ ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
O r
TIME: ~
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON gy
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