BP12237City of Blair Building Permit Detail
Permit #: 12237 Issued: 8/29/2005 Type: Industrial/Commercial -Remodeling
Completed: 2/9/2006 Valuation: 500
Location: 444 S. 17th Street
Owner: Campbell-Arran Funeral Home Permit Fee: 15
Address: 444 S. 17th Street Issue Fee: 15
Deposit Amt.:
Blair, NE 68008 Receipt #:
Phone: 402 426 2191
Section: Township: Range:
Subdivision: Lot: Block:
Took out 2 temporary partitions and installing permanent ones. Will have electric in one partition.
Contractors
Hardy Construction, Inc.
Dick's Electric
Remarks
General Contractor
Electrical Subcontractor
Permit # Issued
E2287 8/29/2005
9/1/2005 DEM
Inspections Date By
8/30/2005 DEM
8!30/2005 DEM
2/9/2006 DEM
2/9/2006 DEM
Sent copy of permit. Brandy
Electrical Rough-ins
Framing
Electrical Final
Final Inspection of Project
Pass
Pass
Pass
Pass
BUILDING PERMIT APPLICATION
Ir~° ~~~_ Jurisdiction of City of Blair, Nebraska
Permit Fee: ~ oU 218 South 16th Street
Issuance Fee: ~~ ~ U~) ~ ~ Blair, Nebraska 68008 12 2 3 7
Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: ,
Issue Date: ~ ~ _ ~ ~ Type:
JOB ADDRESS
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LEGAL
1. DESCR.
^ SEE ATTACHED SHEET
OWNER
2. M ESS
- /y/~GUj7 ~~p
Gr//u Zlp HOME PHONE
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WORIgCELL PHONE
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3 CONTRACTOR ~, A
/ 1~~ AIL ADDRESS
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Zlp WORK/CEOLL PHONE ~o~~ ~~
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4. Class of Work: NEW
^
ADDITION REMODEL ^ OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work; ~ ~ ~~ ~ ~ ° .-GG~7"L~ l ~
~/ 0~7
6. Valuation of Work: $ ~d~, ~'~ Total Sq. Footage QRCmdiRg easement and Garage): Total Finished Area:
Floodway
7. FIOOdplain: Fringe Q Yes Q No Dev. Permit
Q Yes Q No BFE Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ,~JYes ^ No
10. Special Use Permit Required:^ Yes ~No
11. Variance Required: ^ Yes ~f No
12. Minimum Setbacks: Front ~~ I e Rear -
13. Sidewalk Required: ~ es ^ 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 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 daysor is not complet~within 2 years of date of issue.
SIGNATURE OF
^ Site Plan Attached ^ om lete Plans Attached
Approximate Completion Date
Inspections equired and Fees
il' i
Sewer Water S
Septic Remote
Stop Box Card
iBu Idina
Footings all
PRIOR TO PING)
Fr ng ' a
I c ri I ~/~~
R -I~ F' _ es
Temporary Service
9 as
ATE M h ni
Rough-in _
Comment:
MEET 1BC, IRC, IPC, IMCAND NEC COOER~QUIREMENIS
Final
I mb'n .
Ground Work
Rough-in
Final
WHEN PROPERLY VALIDATED (IN THIS
Permanent Service
A1C
PERMIT
~./ Rev. ells
POUNDS PRIG: Blalr, NE
ELECTRICAL PERMIT APP
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
Application Date: ~ " ~~'" y~
LI CATI O N
Permit E 2 2 8 7
Permit Fee: $ ~°~'~°~~
JOB ADDRESS
~~~~ ~, r1
LEGAL
1 • DESCR. O SEE ATTACHED SHEET
~ /MAIL ADDRESS ZIP
2 NER
y
~
1 S
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yyORKICELL PHONE
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NTRA MAIL ADDRESS PHONE HOME PHONE
3
. WDRK/CELL PHONE
4. Class of Work: p NEW RESIDENTIAL O NEW COMMERCIAL REMODELING/ADDITIONS O UPGRADE SERVICE
5. Describe Work: ~~~~ ~
6. Current License on File Q Yes p No O NA Completion Date
New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00
101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00
201-300 Amp Fee ............................ $ 30.00 Fire Alarm System ................. $10.00
301-400 Amp Fee ............................ $ 42.00 Signs ..................................... $15.00
401-500 Amp Fee .......................:.... $ 55.00
501-600 Amp Fee ............................ $ 67.00 Miscellaneous Apparatus ...... $11.00
601-700 Amp Fee $ 80.00
............................ AC/DC Circuit ........................ $5.00
701-800 Amp Fee . . $ 92.00
801-900 Amp Fee ............................ $105.00 Commercial/Multi-Family and All Upgrades:
901-1000 Amp ................................. $117.00 # of Circuits x $2.00
IF OVER 1000 Amp Amp Fee
1st 1000 Amp Fee ....:.................. $117.00
Each additional 100 Amps ........... $ 13.00 Amp Fee + Circuit Total
New Residential: (Finished Area)
NOTICE Single/Two Family Dwellings
I hereby certify that I have read and examined this sq. ft. x .045
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of Modular/Manufactured Homes ....... $30.00
work will be com
lied
ith
h
th
ifi
d h
i
t
p
w
w
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er spec
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ere
n or no
.
The granting of a permit does not presume to give authority
t
i
l
t
l th
i
i
f
h ~ Receptacle/Switch Outlets
Z
~
~
o v
o
a
e or cance
e prov
s
ons o
any ot
er state or local Fixtures o
l)~ ~
1 x $.75
law regulating construction or the performance of Smoke Detectors x $3.00
construction.
Residential/Commercial Appliance
# Fixed Outlets x $3.00
Motor(s) x $3.00
Power Apparatus (220 Volts)
SIGNATURE OF CONTRACTOR OR AUTHORIZE AGENT ' # Apparatus x $3.00
l~'~~'`°~~` Permit Issuance Fee .............$15.00 ~~°~J
DATE
TOTAL ~° a
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By: G - I
POUNDS PRTG.-Blair, NE Rev. 11/99
q ~ BUII,DING INSPECTION REPORT
^ CTI'Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
~
` ~ ` ~ ~ ~
LOCATION OF INSPECTION• `
'"~^~'~''
'
"" • "
NAME OF OWNER_
W
~
~ C.ONTRACTOR~ 'i~ "
~
it ATA TT~TC'D~!'TTl1T~T DII/li TIICT~TI. `~+ _ ~ ~ TTTAC TnTC`DL'!Ti`7/~A7 oL`n77L`C'TL`ll. ' U\ ~ ~ nrna.rtm win.
a.aaaal as va u~.aava. au.~va..v ai.Y au.ia.. u~vi a.uiiv~~lu.:~vi~~11.L- 1 ll'.1~1Y111 1V
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE V
^ STATUS CHECK
BUILDING: ^
COMMENTS: FOOTING ^ DECK FOOTING FRAMING ^ DRYWALL' ^ FINAL ^ PARTIAL . PASSE FAILEI
UTILTPIES: ^
^
COMMENTS: SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE
PARTIAL PASSED ,
^ FAILEI
^
ELECTRICAL:
^
COMMENTS: ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT
PARTIAL PASS
~
~~~/// FAILEI
^
MECHANICAL: ^
COMMENTS: ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED
^ FAILEI
^
PLUMBING: ^
^
COMMENTS: GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATERMETERTNSTALLED ^ PARTIAL
PRESSURE TEST PASSED
^ FAIL.E]
^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS•
INSPECTO ~ - OF INSPECTION MADE: ~~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY `</
T ` ~ v
BUILDING INSPECTION REPORT i
~TI'Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPE -ION• ~ ' I ~~ L} ~•
NAME OF OWNER• ~~ / ~J~ ~~~ ONT~CT~ ~ V 7 ~/Gl/ ~~~
DATE INSPECTION REQUESTED•~ / r U~ TIME INSPECTION REQUESTED• ~~ PERMIT NO• /~°~~
TYPE OF INSPECTION REQUESTED:
^ CONFERENCE ^ STATUS CFIECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ` INAL ^ PARTIAL PASS FAILED
COMMENTS:
UTILTPIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
COMMENTS: ^ PARTIAL ,r ^ ^
ELECTRICAL: ^ ROUGH IN FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS FAILED
COMMENTS: ^ PARTIAL ~ ^
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 MADE:
r
T /
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON ~ B
CITY OF BI,~IR
Ar~
o~~se of
BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet .includes various items dealing with particular code
requirements and/or building 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 packet is only
designed and distributed to aid you in your building 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
~~
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail crfyofblair@huntel,net
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