BP10471City of Blair Building Permit Detail
Permit #: 10471 Issued: 6/22/2004
Completed: 11 /17/2005
Location: 2357 Elm Drive
Owner: Lloyd Olson
Address: 2357 Elm Drive
Blair, NE 68008
Phone: (402) 676-5432
Section: Township: Range:
Subdivision:
roofing; siding; gutters
Contractors
Cedar Valley Exteriors, Inc
Remarks
Type: Roofing permits -All types
Valuation: 5991.5
Lot:
General Contractor
11/17/2005 STATUS Roof completed per contractor. No final.
Permit Fee: 15
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
I DUILDING PERMIT APPLICATION
~ ,~ Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee; Blair, Nebraska 68008 10 4 71
Receipt #; (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: ~ 1
Issue Date: Q ~ Type: ~~ ~ •5 ~ C~ t n Cq
JOB ADDRESS _
~~
LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
0 N R
2, ~
~ MAIL ADDRESS Zlp HOME PHONE
WORK/CELL PHONE ~ .~~~~'
C NT C R
S.
~ MAIL ADDRESS
~ 3t2,0 c ZIP SAC- l~i,~ G} HOME PHONE ,b ~'
~ j ~ ~,~ 1 WORK/CELL PHONE ~ ~ _ aa~
4. Class of Work: ^ EW ^ ADDITION ^ REMODEL OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work: ~0 ~ n 5 ~ I ~1.~- r~
6. Valuation of Work: $ ~~~ (~~J- ® Total Sq. Footage pRCluaingBasementanaGaragel: Total Finished Area:
Floodway
7. Floodplain: Fringe ^ Yes Q No
O Yes Q 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 mysignature below, I acknowledgethat 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 bythe 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 ifwork is notcommenced within
180 days or is not completed within 2 years of date of issue,
SIGNATURE
Comment:
^ Site Plan Attached ^ plete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer Water S
Septic Remote
Building
Footings
Framing
EI c rical
Rough•in
Final
Temporary Service
Mech,~nical
Rough-in
Final
Plumbing
Ground Work
Rough-in
WHEN PROPERLY VALIDATED
Approved By: I~ 4-•F~~' I
Stop Box Card _
Drywall
(PRIOR TO TAPING)
Final
Fixtures
Permanent Service
A1C
Final
THIS SPACE) THIS IS YOUR PERMIT
Rev.8/96
POUNDS PRTG.-Blair, NE
CITY OF BI~.~II~
aroma/se of aJ~`\
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.
,. ~.
~
,C! ~
Owner/Occupant
City of Blair
Contrac~
~~
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cityofblair@ci.blair.ne.us ~ •~~~