BP11065City of Blair Building Permit Detail
Permit #: 11065 Issued: 07/22/2004
Completed: 11 /17/2005
Location: 2266 Hickory Circle
Owner: Matt Olsen
Address: 2266 Hickory Circle
Blair, NE 68008
Phone: 426-4735
Section: Township: Range:
Subdivision: Lot:
Tear off one layer and replace with asphalt shingles
Contractors
Hillman -Schmidt
General Contractor
Remarks
11/17/2005 STATUS Roof completed per contractor. No Final.
Type: Roofing permits -All types
Valuation: 3900
Permit Fee: 15
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
. BUILDING PERMIT APPLICATION
~~~-~ Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008 1 10 6 5
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #:
Issue Date: ~ " ~2'vW Type:
JOB ADDRESS ~ ~ ~ ~ ~ c
LEGAL
1. DESCR.
^ SEE ATTACHED SHEET
OWNER
2, ~ MAIL ADDRESS Zlp HOME PHONE ~f ^
WORK/CELL PHONE 1 ~ ~ " ~3
CONTf' C 0 r
3, ;~1 ~~ "° ~~ ~! ~, MAILADDRESS
,~ ZIP HOME PHONE
WORKICELL PHONE
4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL ^ OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work: I ~~ A
6. Valuation of Work: $3S ~ ~ Total Sq. Footage (Incluliing Basement ana Garage): Total Finished Area:
Floodway Q Yes
7. Floodplain: Fringe Q Yes Q No Dev. Permit
Q No 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 Side Rear
13. Sidewalk Required: ^ Yes ^ No Waiver Approved
^ Site Plan Attached ~ ~~ o~glete Plans Attached
Approximate Completion Date ``((
Inspections Required and Fees
Utilities
Sewer -
Septic _
B it in
Footings
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septic systems. By my signature below, I acknowledge that 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 by the Building
Inspector.
I hereby agreeto 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 notcommencedwithin
18 ys o is not completed withi 2 years of date of issue.
n ~n. i9~
Comment:
OF
DATE
Framing
E ri I
Rough-in
Final
Temporary Service
M h ni
Rough-in _
Final
PI m in _
Ground Work
Rough-in
Water Service
Remote
Stop Box Card -
Drywall
(PRIOR TO TAPING)
Final
Fixtures
Permanent Service
A1C ,
Final
WHEN PROPERLY VALIDATED (IN THIS
Approved By: ~ n
THIS IS YOUR PERMIT
POUNDS PRTG: Blair, NE ~ R~• 8/96
Cl'I'Y OF BI,~SIR
.z __
pro _~ .. J~\`~~~
~i~se of a
ROOFING PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and/or roofing permit requirements. It in no way includes QLL particular
code items. Also, it is your responsibility to know the 2003 International Bu((dinc~
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing permif 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.
Owner/Occupant
City of Blair
C ntractor
,-~~~ .-~
Date
218 South 16th. Street • Blair, Nebraska 68008 •-402-426-4191 ,• Fax 402-426-4195 E-mail ciiyofblair@ci.blair.ne,us