BP11343
City of Blair Building Permit Detail
~,
Perrr~it #: 11343 Issued: 8/16/2004
Completed: 5/4/2005
Location: 1142 S. 16th Street
Owner: Michael & Mary Jo O'Hanlon
Address: 1142 S. 16th Street
Blair, NE 68008
Phone:
Section: Township: Range:
Subdivision: Lot:
Tear off one layer and replace with 30-year composition shingles
Contractors
Jim La Hood Construction, Inc.
General Contractor
Remarks
type: Roofing permits -All types
Valuation: 6500
Permit Fee: 15
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit # Issued
Inspections Date By
5/4/2005 DEM Final Inspection of Project Pass
BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
Permit Fee: ~ ~~X~ 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008 113 4 3
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: `
Issue Date: ~~ Uy Type: ~~U' ' ~~
JOB ADDRESS f ~ ~
I ~ ~ ~~ ~ I '
LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
OWNER ~~ --.
2. I C ,~"lG(r Q M I DRESS ZIP HOME PHONE
WORKICELL PHONE
CO CTOR ~ ~~ U l~V'1
S. V' 1 MAI DDRESS ~~ ~ ~~ ~ZIP~~~ OMEPHONE ~ 3--~~~~~
WORKICELL PHONE
4. Class of Work: NEW Q ADDITION ~ REMODEL Q OTHER Q FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work: ~'d ~~ ~ / ~ `,~~ ~ U''/) ~
3 ~
6. Valuation of Work: $ (p ~ (,~(~ • ~ Total Sq. Footage pDDmding Basement ana Garagel: Total Finished Area:
Floodway Q Yes Q No
7. FIOOdplain: Fringe Q Yes Q No Dev. Permit
BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ~ Yes
10. Special Use Permit Required: Q Yes
11. Variance Required: ^ Yes Q No
Q No
Q No
12. Minimum Setbacks: Front Side Rear
13. Sidewalk Required: Q Yes Q No Waiver Approved .
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 bythis permitapplication shall not be
commenced until I have received a copy of this application form signed by the Building
Inspector.
I hereby agree to perform the proposed work in accordance with the specifications set
forth above and in accordance with the codeslordinances of the City of Blair and the
Stateo braska.lunderstandthatthispermitisvoidifworkisnotcommencedwithin
180 ys r is not co~eted within ears of ~ of issue.
OF OWNER/CONTRACTOR
Comment:
DATE
O Site Plan Attached ~ / O ~ n}~Iet~ Plans Attached
Approximate Completion Date ~ / ~J
ili i Inspections Required and Fees
Sewer Water Service
Septic Remote
Stop Box Card
Buil in
Footings Drywall
(PRIOR TO TAPING)
Framing Final
Electrical
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A\C
Final
PI m in .
Ground Work
Rough-in _
Final
WHEN PROPERLY VALIDATED (IN THIS SPACE THIS IS YOUR PERMIT
Approved By: ~ ~,
POUNDS PRIG: 81air, NE r ~ l~ R~• 8/96
~4 ~~' - _
TI'Y OF BLAIR
/LOCATION OF INSPECTION:
l
NAME OF OWNER:
. , ~ , w. -~ -- -
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY ^ OTHER
/t//
DATE INSPECTION REQUESTED• S G ~ TIME INSPECTION REQUESTED• / ( l PERMIT NO: e/ ~7`
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ~ FINAL ^ PARTIAL PASS FAILED
COMMENTS: ~ ^
UTILITIES: ^
^
COMMENTS: SEWER TAP ^ SEWER ^ SEPTIC ^ .WATER TAP ^ REMOTE ^ WATER SERVICE
PARTIAL PASSED
^ FAILED
^
ELECTRICAL: ^
^
COMMENTS: ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT
PARTIAL PASSED
^ FAILED
^
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: ^ ^
PLUMBING: ^
COMMENTS: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL
PRESSURE TEST PASSED
^ FAILED
^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
INSPECT6 DATE OF INSPECTION MADE: v
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON By
CITY OF BI;t1IR
- _ ~~~.
aro~~se of a`~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 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.
Owner/Occupant
City of Blair
ontractor
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cityofblair@ci.blair,ne,us