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BP12224City of Blair Building Permit Detail Permit #: 12224 Issued: 8/16/2005 Type: Siding Permits -All types Completed: 2/28/2006 Valuation: 9500 Location: 11007 C. Rd. 29 Owner: Gayle Carey Permit Fee: 15 Address: 11007 C. Rd. 29 Issue Fee: Deposit Amt.: Blair, NE 68008 Receipt #: Phone: 402 426 8185 Section: Township: Range: Subdivision: Lot: Block: West side and North end new metal siding. Replacing metal roof also. Storm damage. Contractors Jorgensen Contracting, Inc. General Contractor Permit # Issued Remarks Inspections Date By 2/28/2006 DEM Final Inspection of Project Pass BUILDING PERMIT APPLICATION ~. ~ Jurisdiction of City of Blair, Nebraska Permit Fee: 218 South 16th Street Issuance Fee: Blair, Nebraska 68008 Receipt #: (402) 426-4191 • Fax (402) 4~ 26-4195 Permit- Deposit Receipt #: _ ~' ~ '~ ~ ~ ~ ~~ ~ ~~ Issue Date: TvrJe: < ~/ 12224 JOB ADDRESS ~ ~~ LEGAL 1. DESCR. ^ SEE ATTACHED SHEET OWN 2. ~ MAIL ADDRESS ~C2~,P Zip HOME PHONE WORIVCELL PHONE ~~~ ~/~ CONTRACT 3. MAI DDRESS ~~~ ~~,(/f7 ZIP HOME PHONE WORK/CELL PHONE 4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL ^ OTHER ^ FIN I SHED BASEMENT- ^ UNFINISHED BASEMENT 5. Describe Work: ~,~ L ~ 4 i~~~'CJ J7 /?~~~ ~~ a ~ ~~ a erg ~~ ~~ 6. Valuation of Work: $ QD, o~ Total Sq. Footage pnc~uaing easement ana Garage): Total Finished Area: Floodway ^ Yes ^ No Dev. Permit 7. FIOOdplaln: Fringe ^ Yes Q No BFE Elev. CerL 8. Current Zoning: 9. State Fire Marshall Required: ^ Yes 10. Special Use Permit Required: ^ Yes 11. Variance Required: ^ Yes ^ No 12. Minimum Setbacks: Front 13. Sidewalk Required: ^ Yes ^ Nc ^ No ^ No Side Rear 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 furtheragree that construction covered bythis permit application shall not be commenced until I have received a copyofthis 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 if work is not commenced within ys or is not comp`)withi~n ~2,ye~a~rs~of~date of iss/~ ~/ Comment: ^ Site Plan Attached ^ Complete Plans Attached Approximate Completion Date' ~•'S "~~~ Inspections Required and Fees utilities ', Sewer Septic Bilin i Footings Framing Electrical Rough-in Final Temporary Service h ni Rough-in Final PI m in Ground Work Rough-in WHEN PROPERLY VALIDATED Drywall (PRIOR TO TAPING) Final Fixtures Permanent Service A1C Final Approved Bfy: ~ . ~ Water Service Remote Stop Box Card THIS SPACE) THIS IS YOUR PERMIT POUNDS PRiG: Blair, NE Rev. e/9e CITY OF BLAIR BUILDING INSPECTION REPORT ^ WASHINGTON COUNTY LOCATION OF INSPECT ON• /v NAME OF OWNER• ~ ` ~(.~' C~ ~~Q DATE INSPECTION REQUESTED•~ a~ ~ TIME INSPECTION REQUESTED: ~ ~ PERMIT N0:/ aaa T TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS C~IECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL F IN A L ^ PARTIAL PASS FAILED COMMENTS: ( ~ ~ / f,~~ UTILITIES: ^ SEWER TAP ,^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: - ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ -FINAL ^ PARTIAL PASSED FAILED ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED ^ PRESSURE TEST ^ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED DATE OF INSPECTION /`~^ OTHER /~~ 1 ~. ~~U ~~ c TIME: ~ ~ ~C/ FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY