BP12143City of Blair Building Permit Detail
Permit #: 12143 Issued: 06/20/2005 Type: Roofing permits -All types
Completed: 01/04/2006 Valuation: 11000
Location: 1128 Nebraska Street
Owner: Daniel Anderson Permit Fee: 15
Address: 1128 Nebraska Street Issue Fee:
Deposit Amt.:
Blair, NE 68008 Receipt #:
Phone: 402 533 8401
Section: Township: Range:
Subdivision: Lot: Block:
Garage tear off one layer and replace with asphalt. Gutters and Siding. House-Roof-Tear off 1 - 3 layers and replace
with asphalt Gutters and
Contractors
SELF General Contractor Permit # Issued
Remarks
01/04/2006 STATUS No final was done.
Inspections Date By
-~, BUILDING PERMIT APPLICATION
Jurlsdlctlon of Clty of Blair, Nebraska
Permit Fee: ~J:~ 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008
Receipt #: (402) 426-4191 • Fax (402) 426-4195
Deposit Receipt #:
Issue Date: ~,!~ ~ ~ Type:
JOB ADDRESS ~ 1 ~~
LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
NER
2, ,~ ~
I~ MAIL ADDRESS ZIP HOME PHONE (
WORKICELL PHONE ~3~ "'
CONiRp~~
'3, t11 MAILADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL ~ OTHER ED BASEMENT
^ FINISHED BASEMENT ^ UNFINISH
5. Describe Work: (~Y' ~ ~ - ~ ~ ~ ~~~ l (~, )
~ ~ (~ ~ ~ /"(
~- n
6. Valuation of Work: $ ~ ~ Total Sq. Footage pRCIuaIRgBa6ementandGaragei: Total Finished Area:
Floodway
7. Floodplain: Fringe Q Yes ^ No
O Yes ^ No Dev. Permit
BFE Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes
10. Special Use Permit Required: ^ Yes
11. Variance Required: ^ Yes ^ No
^ No
^ No.
12. Minimum Setbacks: Front Side Rear
13. Sidewalk Required: ^ Yes ^ No Waiver Approved .
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septic systems. By my signature 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 by the Building
Inspector.
I hereby agree to perform the proposed work in accordancewith the specifications set
forth above and in accordance with the codes/ordinances of the City of Blair and the
State ofNe aska.lunderstandthatth' ermitisvoidifworkisnotcommencedwithin
180 days ors not com~lfeted within ~y ars of ate of issue. / ,
Comment:
OF OWNERICONTRACTOR
/ ~,
DATE
Permit
12143
^ Site Plan Attached ~r~ , „^ Cgmplet~Plans Attached
Approximate Completion Date ~ {/ / ~CX~
Inspections Required and Fees
iUt lities
Sewer Water Service
Septic Remote
Stop Box Card
B it in
Footings Drywall
(PRIOR TO TAPING)
Framin Final
g
I ric I
Rough-in Fixtures
Final Permanent Service
Temporary Service
M h ni
Rough-in A1C ,
Final
PI m in
Ground Work
Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: I r _ ~
' ~ Rev. 8/96 '
POUNDS PRIG: Bletr, NE
CITI' OF BI,t1IR
~r~~~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.
and accept this building permit documentation on my
ibility as the owner/contractor for this project.
Contractor
City of Blair
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mall cilyofblair@ci.blair.ne,us
have read the above disclosure
own behalf assuming full respons