BP12013City of Blair Building Permit Detail
Permit #: 12013 Issued: 04/04/2005 Type: Roofing permits -All types
Completed: 01/04/2006 Valuation: 1500
Location: 2353 Park Street
Owner: Jim Cordle Permit Fee: 15
Address: 2353 Park Street Issue Fee:
Deposit Amt.:
Blair, NE 68008 Receipt #:
Phone: 402 426 5266
Section: Township: Range:
Subdivision: Lot: Block:
Tearing off to put ice barrier on. Will be covering one layer of shingles with asphalt shingles.
Contractors
SELF General Contractor Permit # Issued
Remarks
01/04/2006 STATUS No final was done.
Inspections Date By
BUILDING PERMIT APPLICATION
~~ Jurisdiction of City of Blair, Nebraska
Permit Fee: ~ 218 South 16th Street
Issuance Fee: Blair, Nebraska 68008 12 013
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: ~ . ~~
Issue Date: / ~ ~~ Type:
JOB ADDRESS 1 ^ ~~
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LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
OW
`L, MAILADDRESS ZIP HOME PHONE ` /
WORK/CELL PHONE ~ d~„b ~ S~ (O
CONT OR
`3, MAIL ADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class of Work: Q NEW Q ADDITION Q REMODEL Q OTHER ^ FINISHED BASEMENT Q UNFINISHED BASEMENT
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5. Describe Work: ~
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6. Valuation of Work: $ ~,5~ () ~ Total Sq. Footage QRCIuaIRg 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: Q Yes O No
Q Site Plan Attached Q Complete Plans Attached
Approximate Completion Date ~ ' ~ QS~
Inspections Required and Fees
10. Special Use Permit Required: Q Yes Q No
11. Variance Required: Q Yes Q No
12. Minimum Setbacks: Front Side .Rear
13. Sidewalk Required: O Yes O 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 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 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 if work is not commenced within
180 days or is not completed within 2 years of date of issue.
~ATURE OF OWNER/CONTRACTOR DATE
Comment:
POUNDS PRIG: Blair, NE
U ili ie
Sewer Water Service
Septic Remote
Stop Box Card
B it in
Footings Drywall
(PRIOR TO TAPING)
Framing Final
E c ri
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A1C
Final
Plumbing
Ground Work
Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By:
Rev. B/96
CITY OI' BI~.~IR
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a~o~~se f ` q J~~~
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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.
caner/Occupant
City of Blair
Contractor
4 - /.-- ~~-_-~
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cifyofblair@ci.blair,ne.us