BP10250~ .~ 5 31 ~~ v ~ ~ ~a5~
Blair Building Permit Detail
Permit #: 10250 Issued: 6/9/2004 Type: Residential Remodeling
Completed: 5/25/2006 Valuation: 40000
Location: 1952 Grant Street
Owner: Chad Gibson Permit Fee: 200
Address: 1952 Grant Street Issue Fee: 15
Deposit Amt.:
Slair, NE 68008 Receipt #: 11597
Phone: 278-0585
Section: Township: Range:
Subdivision: Lot: Block:
Remodel first and second floor and put a new basement under house -gut; will have three bedrooms and bathroom
upstairs; main floor will be kitchen/living w eat in/ bathrrom & laundry room; unfinished basement with RI bathroom
Contractors
SELF General Contractor Permit # Issued
SELF Heating Subcontractor M1290 8/26/2005
SELF Electrical Subcontractor E2286 8/26/2005
SELF Plumbing Subcontractor P1173 11/19/2004
Remarks
1/6/2006 STATUS Have a bad phone number for. Progress has been made up through Novermber, 2005.
11/29/2005 DEM Fireplace needs draft stop.
2/13/2006 DEM Nobody Working.
2/15/2006 BMS Called and left a message for Chad about status.
2/22/2006 BMS Dale finally got a hold of Chad Gibson, he set inspecion up for 2/23/06. changed completion
date to that also.
2/28/2006 DEM Underside of Stairs shall be drywalled.
2/28!2006 DEM 30 days. Changed completion date to 3/31/2006.
3/28/2006 BMS Changed completion date per Dale to 6/1/2006.
5/3/2006 BMS Hard surface parking and sidewalk. 30 days per Dale. changed completion date to 6/2/2006
` Blair Building Permit Detail
5/24!2006 DEM Occupancy Granted.
Inspections Date By
9/28/2004 DEM Footings Pass
7/6/2005 DEM Plumbing Groundwork Pass
7/6/2005 DEM Plumbing Pressure Test Pass
11/29/2005 DEM Plumbing Rough-ins Pass
11/29/2005 DEM Framing Pass
11/29/2005 DEM Electrical Rough-ins Pass
11/29/2005 DEM Electrical Permanent Service Pass
11/29/2005 DEM Mechanical Rough-ins Pass
2/9/2006 DEM Status check Fail
2/21/2006 DEM Status check Pass
2/27/2006 DEM Framing Pass
2/27/2006 DEM Electrical Rough-ins Pass
2/27/2006 DEM Plumbing Rough-ins Pass
5/2/2006 DEM -Final Inspection of Project Fail
5/2/2006 DEM Electrical Final Pass
5/2/2006 DEM Mechanical Final Pass
5/2/2006 DEM Plumbing Final Pass
5/25/2006 DEM Final Inspection of Project Pass
Partial
Partial
Partial
Partial
BUILDING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
Permit Fee: ~~ ~~~ ~~ ~.~ 218 South 16th Street
Issuance Fee: IS~(~ ~ Blair, Nebraska 68008
Receipt #; ~ r}() 02) 426-4191 • Fax (402) 426-4195 Permit
10250
Deposit Receipt #: ~ ~ ~ ~.
/ Z ,CX~
Issue Date: 1~ ~ ~ ~ ~ ~' TyNe:_~
JOB ADDRESS
1
LEGAL
1 . DESCR.
^ SEE ATTACHED SHEET
2 W ER ` C
U~' 1 ~ AILADDRE,S6
~ ~ ZIP HOM~9N ~ ~~~5
WO CELL P ONE
CO TRACTQR
3, 't T/ ` MAIL ADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class of Work: ^ NEW ^ ADDITION REMODEL ^ OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work: ' ~~~~ ~~S ~ ~~~~~{ ~~~ (~ ~~5~ {'?'LSZ~
n~ ^~ ~. ~~ 3 ~ MoD ins -~' (~a~~r~rn 'c -
~~. L~,t~ ~ ~ 011 ~ n f~c~?nrrn
lQ.~.,1Li~-1, ~~ a~-~v-~ c~-h -~~--v,-
6. Valuation of Work: $ ~ a% Total Sq. Footage pnclualRg Basement ana Garage): Total Finished Area:
Floodway Q Yes
7. FlOOdplain: Fringe Q Yes Q No Dev. Permit
Q No BFE
Elev. Cert.
( y~ ^ Site Plan Attached ^ Complete Plans Attached
8. Current Zoning: ~
Approximate Completion Date
9. State Fire Marshall Requir o ~p¢¢ql~
10. Special Use Permit Req~- ^ "^c--~ No~,,~
11. Variance Required: ^ Yes ^ No ~!"~~
12. Minimum Setbacks: Front ~~ Side ~ Ream
13. Sidewalk Required: 'Yes ^ No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, heat-;, ventilating and air
conditioning, and septic systems. By my signature below, I ackn~ ,vlt:dge that payment
of the building permit application fee does not constitute issti~~ nc~ of this building
permit. I further agree that construction covered by this permit application shall not be
commenced until I have received a copy ofthis 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 that this permit is void if work is not commenced within
180 days o 's n co pl to within 2 years of date of issue.
S ~r ~ Q
IGNATURE OF OWNS ONTRACTOR DATE
Comment:
M~~r~~~,-iac ~,~c ar~o~c coaE a~au~~~MENrs
SCEEPiNG ROOMS BELOW THE FOURTH
STORY AND IN BASEMENTS ARE -
REQUIRED TO HAVE AN EGRESS WINDOW,:
Inspections Required and Fees
Utilitie
S er Water ice
Septic
Buildin
Foo ' gs
F'~ al
Service
~aetote
Stop,66)t Card
Drywall
(PRIOR TO TAPING)
Fi I
Firs
Pe Went Service
~mbin
ork
Rott~i.irt'
WHEN PROPERLY
IN THIS SPA~~iIS IS YOUR PERMIT
. Rev. 8/96
POUNDS PRTG: BIaIy NE
I`
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191 Permit E 2 2 8 6
0
Application Date: ~ _ ~` 6 ~ U ~ Permit Fee: $ S a'
JOB ADDRESS r q r-~
( ` ~
1 LEGAL
O SEE ATTACHED SHEET
DESCR.
2. OWNE ~~ MAILADDRESS ZIP WORK/CCELLPHONE ~ l~-0~" Jr
3 CONTRAC OR MAIL ADDRESS PHONE HOME PHONE
WORKICELL PHONE
4. Class of Work: p NEW RESIDENTIAL O NEW COMMERCIAL REMODELING/ADDITIONS O UPGRADE SERVICE
5. Describe Work: ~~
6. Current License on File O Yes O No O NA Completion Date u' ,?i ~ 'C~
ELECTRICAL PERMIT FEES
New Service Fee = (Amp Fee + $2.00 per branch circuit)
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 S stem $10.00
y
301-400 Am Fee $ 42.00
p ............................ Signs .......... $15.00
...........................
401-500 Amp Fee ............................ $ 55.00
501-600 Am Fee .. $ 67,00
p .......................... 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 JJ,,,,
0
~
~ ~ ~ " W
I hereby certify that I have read and examined this b O
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 complied with whether specified herein or not.
The granting of a permit does not presume to give authority Receptacle/Switch Outlets
to violate or cancel the provisions of any other state or local Fixtures 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 CONTRACTOR OR AUTHORIZED AGENT # Apparatus x $3.00
~- z( ~-(~',~ Permit Issuance Fee $15.00 C~' ~'~
DATE r
TOTAL -
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
'OUNDS PRTG.-Blair, NE Rev. 11/99
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 12 9 0
Fax (402) 426-4195 M
(402) 426-4191
A lication Date: Q' / ' ~ r.
Pp U ~b ~ Permit Fee: $ ~ '~J
JOB ADDRESS
l S.~a ~~ ~
1 . OWNER /(~ (~ ~, a . MAIL ADDRESS ZIP PHONE
2 CONTRACTO MAIL ADDRESS PHONE LICENSE NO.
3• Class of Work: O COMMERCIAL RESIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR REPLACEMENT
4• Describe Work: ~
Central A/C a' Tons MECHANICAL PERMIT FEES
Furnace ~y ~ J J `~ BTU/H Forced Air/Heat Pump Systems -Per Unit
Commercial/Residential (New) .................................................... $25.00
# of Units A/C
Air-Conditioner Unit -Per Unit
Furnace Commercial/Residential (New) .............................. ...................... $10.00
Forced Air Systems/Air Conditioner ~~'"~'~
' ~~
Completion Date: ~' ~ u , J Unit Replacement Per Unit Commercial/Residenti al ................ $10.00
Refrigeration Units/Coolers/Lines/Compressor - ~ ~ ~~J
Comments:
Per Unit Commercial (New or Replacement) ......
..................... $10.00
Appliance Vent/Fans ............................... $10.00 ~~ ` ~
Boiler ....................................................... $15.00
Duct System $10.00 ~~ " UL7
Gas/Air Outlets .................. x $2.00
NOTICE Radiant Heat Systems ............................ $25.00
I hereby certify that I have read and examined this
a
lication and know th
t
b
pp
e same
o
e true and correct. All
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
Modular Home ......................................... $15.00
The grantin
of a
ermit does not
r
t
i
h
i
g
p
p
esume
o g
ve aut
or
ty
to violate or cancel the provisions of any other state or local
P
it I
F ~~(
law regulating construction or the performance of erm
ssuance
ee ............................... $15.00
construction
.
/- TOTAL ~~
cN~-
SIGNATURE 0 CONTRACTOR OR AUTHORIZED AGENT
~6 ~ Current License on File O Yes O No O NA
DATE
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
'OUNDS PRTG: Blair, NE Rev. 4/98
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 117 3
Fax (402) 426-4195 P
(402) 426-4191
~ ~ ~ I ~ ~~~--~
Application Date:
Permit Fee: $ ~~ ~`-'~-~
JOB ADDRESS 1
°~`
1. AW' ER Ili SS ZIP PHON
2 CONTRACT MAIL ADDRESS PHONE LICENSE NO. ~ ~~
3. Class of Work: O COMMERCIAL ~SIDENTIAL O NEW O ADDITION O ALTERATION O REPAIR O REPLACEMENT
4• Describe Work: ~~' U ~}~` r
S
~c
C~1
2
1
a-
~
- ~
~ C l
.
-
- c.~,
~i-,~,
I .~
i n
~ mQ_I~ ~c~
~
Comments: PLUMBING PERMIT FEES
Modular Home ...................... $15.00
Type of Fixture No.
~
Kitchen $8.00 x
..................................
Bath ....................................... $8.00 x -L $' ~~
~ U' w
Rough-In Bath ....................... $4.00 x
Slop Sink/Laundry Tray ......... $5.00 x
Water Heater ......................... $3.00 x
Outside Water Faucet ........... $3.00 x
Drinking Fountain .................. $3.00 x
Water Service ........................ $10.00
NOTICE Sewer .................................... $10.00
I hereby certify that I have read and examined this
Groundwork ...........................$10.00 i
`~`~~
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of
Septic Tank & Laterals ..........$10.00
work will be complied with whether specified herein or not. Lawn Sprinkler System ......... $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local Sprinkler System ................... $30.00
law regulating construction or the performance of
(Commercial)
construction.
Gas/Water Piping System
(Commercial) ............................ $30.00
I ~'L~
Permit Issuance Fee $15.00
SI ATURE RACTOR OR AUTHORIZED AGENT `Q
TOTAL C.J
DATE Current License on File Yes O No ~NA
WHEN PROPERLY VALIDATED (IN THIS SPACE)
Comment:
Approved By:
S IS YOUR PERMIT
POUNDS PRTG: Blair, NE ~ Rev. 4/98
_.._ ___
BUILDING INSPECTION REPORT
^{-CTT~ OF4BLAIR ^ WASHINGTON COUNTY /^ OTHER
LOCATION OF INSPE 'ION• ~ ~ ~^ ~ v fL~~
~~L'~.-~- `~
NAME OF OWNER• CONTRACTOR:
DATE INSPECTION REQUESTED• ~ ~ ~ TIME INSPECTION REQUESTED• ~ ~ PERMIT NO• ~ ~~
TYPE OF INSPECTION REQUESTED: ` ^ CONFERENCE ^ STATUS CHECK
BUILDING: FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASS FAILED
COMMENTS: ~ ^
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ~ ^
COMMENTS:
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT P
^
PARTIAL ASSED :FAILED
COMMENTS: ^
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL
PASSED FAILED
COMMENTS: ^ ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
^ PRESSURE TEST ^ ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
C L~ -
INSPECTO DATE OF INSPECTION MADE: v T /.
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON gy
BUILDING INSPECTION REPORT
Ci`P~OIi$LAIR ^ WASHINGTON CQOUNTGY~ ^~OTHE[R'
LOCATION OF INSPECTION• I 1 ~ v'~ ~ ~~/1 ~ v
NAME OF OWNER• ~~ ~ CONTRACTOR. `-'"' "' ~"-'~
DATE INSPECTION REQUESTED• ~ ~~ ` - -1 TIME INSPECTION REQUESTED• PERMIT NO• ~ ~ ~ a
TYPE OF INSPECTION REOi
^ CONFERENCE
BUILDING: 'FOOTING ^ DECKF
O
OTING
^ FRAMING ^ DRYWALL ^ FINAL PARTIAL PASS FAILED
'COMMENTS: V~ ~ ~ ,
I
~
~.1 - ~ ~ (~ ~Utl .
^
-I3TILITIES: ~ ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP' ^ REMOTE ^ WATER SERVICE PASSED FAILED
' ^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT
^
PARTIAL PASSED
^ FAILED
^
COMMENTS:
MECHANICAL: ^ ROUGHIN ^ 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
T ~ •~
FAXED OPPD~BURT REA
TO CONNECT SERVICE:
^ STATUS CHECK
_~
~PI'1~ OF BLAIR
LOCATION OF INSPECTIO
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY
5
NAME OF OWNER:. ~: ~ ~~ ~ ~~ hS~~r1
~~
^ OTHER
-i G~ n-~
CONTRACTOR
DATE INSPECTION REQUESTED• Co ~ TIME INSPECTION REQUESTED: / ~ ' ~ U r ~ M PERMTI' NO• ~ v~ `~~
TYPE OF INSPECTION REQUESTED:
~~ 1
^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED
^ ^
COMMENTS:
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: ~~ G OUNDWORK ^
i PRESSURE TEST
COMMENTS: ROUGH-IN ^ FINAL
~..~,~
~ f / ~~r~S P ^ WATER METER INSTALLED ^ PARTIAL
~ fY~~Q ~ ~~/~ PAS D FAILED
^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS
inQ~.--
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
( ~,_~,
lTl' OF BLAIR
LOCATION OF
BUILDING INSPECTION REPORT
^ WASHIIVGTON COUNTY ^ OTHI
i95a ~ ~ ~
NAME OF OWNER: ~~Q~ ~ ~ ~~~ ~d ~ ~~ CONTRACTOR • v `-~1/~
DATE INSPECTION REQUESTED• + v ~0
TYPE OF INSPECTION REQUESTED:
BUILDING: ^ FOOTING ^ DECK FOOTING
COMMENTS:
^ DRYWALL ^ FINAL ,PARTIAL
FAILED
UTH,ITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL:• ROUGH IN ^ FINAL ERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS D FAILED
COMMENTS: ~ PARTIAL ~ (1 ~ n ~~~ `\ ~ ^
MECHANICAL ~ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ~ARTIAL PASS D FAILED
COMMENTS: ~ ^
PLUMBING: ^ GROUNDWORK ROUGH-IN ^ FINAL ^ WATER METER INSTALLED PARTIAL PASS FAILED
^ PRESSURE TEST ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
r(/
~~
TIME INSPECTION REQUESTED• ' ' v ~ m ' PERMIT N0: ~a °C ~~
^ CONFERENCE ^ STATUS CHECK
OF BLAIR
LOCATION OF INSF
NAME OF
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY ^
T•
DATE INSPECTION REQUESTED• ~~ ~~ y ~ TIME INSPECTION REQUESTED_ ~ ~ PERMIT NO•
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ~ TATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED 4 _
COMMENTS: v,, w
i'~-~{"/~ ~ ~~~ `/ / ~ I
~ F ~1-t' 9 ~ O~ ~l/~ ~G~~7L~/!~T` Lf!/C~fX// / ^
SIG ^
UTILITIES: ^ SEWER TAP ^ SE WER ^ SEPTIC ^ W R 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
~-~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON
J CITY
LOCATIOI
NAME OF
~ ~f 0 "t /
' ~Q '
'
0~ `
o
DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED:
~/
! ~ /
PERMIT NO• /
-'
~~
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS C~IECK
BUILDING: ^ FOOTING ^ DECK FOOTING FRAMWG ^ DRYWAL ^ PARTIAL PAS .FAILED
^
COMMENTS:
UTILITIES: ^ SEWER TAP '^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL:. -ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ .TEMPORARY SERVICE ^ PRECONNECT PASS 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 PASS FAILED
^ PRESSURE TE T ~ ^
COMMENTS:
^ OCCUPANCY GRANT
J ^ CONDITI
NAL
O
C
C
UPANC
Y
GRA
OI
ANTED ~
ED~
/
`
//
~
~
~J
~
~
I
~~
~ -
~
/
j~ J~/r
®
~~i ~~ "
NOTES/REMARKS: (/(y
lr~~
c_XY ` ~ c.-~c
G'
TTMF• ~D' ~~~
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY ^
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
~`CTI'Y OF B
LOCATION OF
BUILDING INSPECTION REPORT
^ WASHINGTON COUNTY ^ OTHER
/~ A ~ / (y , ~ ---
NAME OF OWNER ~/ Iu t~ ~.l ,l~C J"~`7 CONTRALTO
DATE INSPECTION REQUESTED: ~ ~ ~ ~ `' TIME INSPECTION REQUESTED ~' • 1 "~ ~ PERMIT NO!•~, /~~~0
TYPE OF INSPECTION REQUESTED: t ^ CONFERENCE ^. STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMIIVG ^ DRYWALL INAL ^ PARTIAL ~ PASSED FAIL
^
COMMENTS:
UTILITIES:. ^ SEWER TAP ^ SEWER ^ SEPTIC ^ .WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL : ^ ROUGH IN FINAL ^ PERMANENT SERVICE ^_ TEMPORARY SERVICE ^ PRECONNECT PASS FAILED
^ PARTIAL ~ ^
COMMENTS:
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT L~CFINAL ^ PARTIAL
COMMENTS:
FAILED
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN FINAL ^ WATER METER INSTALLED ^ , PARTIAL PAS FAILED
^ PRESSURE TEST ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
~ ~/ ~ e~ r ,
~~
,v~.
~,ti
T ~~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
BUILDING INSPECTION REPORT
CITY OF BLAIR
LOCATION OFINSPECT/I/ON`
NAMF (1F (1WNFR • l~ ~~Q
^ WASHINGTON COUNTY ^ OTHER.
DATE INSPECTION REQUESTED• ~ J ~J ~ d ~Y TIME INSPECTION REQUESTED: , ~d ~ 30 A • ~• pERMIT N0: /~~~J y
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDIlVG: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PAS FAILED
^
COMMENTS:
UTILTi'IES: ^ 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: ^
COMMENTS: ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED
~ FAILED
^
PLUMBING: ^
^
CO NTS: GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL
PRESSURE TEST PASSED
^ FAILED
^
OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS•
T , ~~' ~°
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON RY
CITY OF BI,~~IR
a~
o~~se of 4
HOMEOWNER VERIFICATION FOR PLUMBING AND/OR
MECHANICAL PERMITS
f~' ~~ C
Print your full name on line above:
~~
states the following:
1. I am the owner of the single family dwelling for which I am applying for a
plumbing and/or mechanical permit.
Address: _ ~.~~ ~~~~
2. I am applying for a plumbing and/or mechanical permit for a single family
dwelling and it is or will be my principal residence.
3. I will install and connect the plumbing and/or mechanical by myself, without
compensation or pay from or to, any other person.
4. I have sufficient knowledge of the 2003 International Code requirements to make
an electrically safe and mechanically secure installation, which will meet the
minimum standards referenced in the 2003 International Code.
5.. I am aware of all inspections required prior to a final.
6. I will call twenty-four (24) hours in advance for an inspection. I am also aware
that it is not the inspector's job or duty to be my instructor in plumbing and/or
mechanical.
7. I am aware that violation of the code makes it a Class 1 misdemeanor to make a
false statement on a request for inspection.
8. By signing this form I am stating the above information is true an correct.
Homeowner/Applicant ip_nature Date
~~
. _
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail ciiyofblair@huntel,net ~~ m
CITY OF' BI,LIIR
9
'fir
o~~se of
HOMEOWNER VERIFICATION FOR ELECTRICAL WIRING PERMITS
Crl4~ ~- ~`5sd~ ,states the following:
print your full name online above:
1. I am the owner of the single family dwelling for which I am applying for an
electrical permit.
Address: ~S~ ~~~
2. I am applying for an electrical permit for a single family dwelling and it is or will
be my principal residence. .
3. I will install and connect the electrical wiring for myself, without compensation
or pay from or to, any other person.
4. I have sufficient knowledge of the 2002 National Electrical Code requirements to
make an electrically safe and mechanically secure installation which will meet the
minimum standards referenced in 81-2104.
5. I am aware of all inspections required prior to a final.
6. I will call twenty-four (24) hours in advance for an inspection. I am also aware
that it is not the inspector's job or duty to be my instructor in electrical wiring.
7. I am aware that Nebr. Rev. Stat. 81-2143 makes it a Class 1 misdemeanor to
make a false statement on a request for inspection.
8. By signing this form I am stating the above information is true an correct.
-~6--US
Date
~~ _
~~
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel.net ,~•~°
CONTRACT FOR DEED
THIS DAY this agreement is entered into by and between Kevin R. Christoffersen,
hereinafter referred to as "SELLER", whether one or more, and Chad M. Gibson, hereinafter
referred to as "PURCHASER", whether one or more, on the terms and conditions and for the
purposes hereinafter set forth:
1.
SALE OF PROPERTY
For and in consideration of ONE DOLLAR {$1.00) and other good and valuable
considerations the receipt and sufficiency of which is hereby acknowledged, Seller does hereby
agree to convey, sell, assign, transfer and set over unto Purchaser, the following property situated
in Washington County, State of Nebraska, said property being described as follows: (Type
description or attach description as exhibit "A')
1952 Grant St. Blair NE 68008
Lot 9, Block 60 City of Blair Washington County Nebraska
Together. with all rights of ownership associated with the property, including, but not limited to,
all easements and rights benefiting the premises, whether or not such easements and rights are of
record, and all tenements, hereditaments, improvements and appurtenances, including all lighting
fixtures, plumbing fixtures, storm windows, storm doors, screens, awnings, if any, now on the
premises.
SUBJECT TO all recorded easements, rights-af-way, conditions, encumbrances and
limitations and to all applicable building anal use restrictions; zoning laws and ordinances, if any,
effecting the property.
- 1-
Contract for Deed
2.
PURCHASE PRICE AND TERMS
The purchase price of the property shall be $78,000.00. The purchaser does hereby agree
to pay to the order of the Seller the sum of Three Thousand Dollars ($3,000.00) upon execution
of this agreement, with the balance of $75,000.00 being due and payable as follows:(Select one)
^ (a) Balance payable in ~~ monthly installments of
Dollars ($~ each, with the first installment being due and.
payable on the day of , 20 and a like payment on the first day
of each month thereafter until the day of , 20 ,when the
final payment shall be due. No interest.
(b) Balance payable, together with interest on the whole sum that shall be from time to
time unpaid at the rate of 8.50 percent, per annum, payable in the amount of $738.55
dollars per month beginning on the 1st day of September, 2003 and continuing on the
same day of each month thereafter until fully paid.
^ (c) Balance payable, together with interest on the whole sum that shall be from time to
time unpaid at the rate of per cent, per annum, payable in the amount of
dollars per month beginning on the day of
20 ,and continuing on the same day of each month thereafter
until the day of , 20 ,when all remaining principal and
interest shall be paid. (Balloon payment)
If interest is charged, interest shall be computed monthly and deducted from payment and
the balance of payment shall be applied on principal.
3.
TIIVIII OF THE ESSENCE
Time is of the essence in the performance of each and every term and provision in this
agreement by Purchaser.
- 2-
Contract for Deed
4.
SECURITY
This contract shall stand as security of the payment of the obligations of Purchaser.
5.
MAINTENANCE OF IlVIPROVEMENTS
All improvements on the property, including, but not limited to, buildings, trees or other
improvements now on the premises, or hereafter made or placed thereon, shall be a part of the
security for the performance of this contract and shall not be removed therefrom. Purchaser shall
not commit, or suffer any other person to commit, any waste or damage to said premises or the
appurtenances and shall keep the premises and all improvements in as good condition as they are
now.
6.
COlVI)ITION OF Il1~IPROVEMENTS
Purchaser agrees that the Seller has not made, nor makes any representations or
warranties as to the condition of the premises; the condition of the buildings, appurtenances and
fixtures locate thereon, and/or the location of the boundaries. Purchaser accepts the property in
its "as-is" condition without warranty of any kind.
7.
POSSESSION OF PROPERTY
Purchaser shall take possession of the property and all improvements thereon upon
execution of this contract and shall continue in the peaceful enjoyment of the property so long as
all payments due under the terms of this contract are timely made. Purchaser agrees to keep the
property in a good state of repair and in the event of termination of this contract, Purchaser
agrees to return the property to Seller in substantially the same condition as it now exists,
ordinary wear and tear excepted. Seller reserves the right to inspect the property at any time with
or without notice to Purchaser.
- 3-
Contract for Deed
8.
TAXES, INS-URANCE AND ASSESSMENTS
Taxes and Assessments: During the term of this contract:(Select one)
^ (a) Purchaser shall pay all taxes and assessments levied against the property.
(b) Seller shall pay all taxes and assessments levied against the property. In the event
that Seller pays the taxes and insurance, Purchaser shall reimburse Seller for same upon 30
days notice to purchaser.
Content Insurance: Purchaser shall be solely responsible for obtaining insurance of the
contents, insuring contents owned. by Purchaser. Seller shall be solely responsible for obtaining
insurance on all contents owned by Seller.
Liability and Hazard Insurance: Liability insurance shall be maintained by Purchaser
during the term of this contract nanung Seller as an additional insured, in the amount of not less
than $'78,000.00.
Fire, Hazard aid Windstorm insurance: Fire, hazard and windstorm insurance shall be
maintained as follows: (Select one)
(a) Purchaser shall obtain fire, hazard and windstorm insurance in the amount not less
than $78,000.00, on a policy of insurance naming Seller as additional insured.
^ {b) Seller shall obtain and pay for hazard, fire and windstorm insurance in an amount
not less than $ . In the event Seller elects this option, Purchaser shall
repay the amount so paid by Seller within thirty (30) days of demand for same by Seller.
Should the Purchaser fail to pay any tax or assessment, or installment thereof, when due,
or keep said buildings insured, Seller may pay the same and have the buildings insured, and the
amounts thus expended shall be a lien on said premises and may be added to the balance then
unpaid, or collected by Seller, in the discretion if Seller with interest until paid at the rate of the
ten percent per annum.
In case of any damage as a result of which said insurance proceeds are available, the
Purchaser may, within sixty (50) days of said loss or damage, give to the Seller written notice of
Purchaser's election to repair or rebuild the damaged parts of the premises, in which event said
insurance proceeds shall be used for such pw-pose. The balance of said proceeds, if any, which
- 4-
Contract for Deed
remain after completion of said repairing or rebuilding, or all of said insurance proceeds if the
Purchaser elects not to repair or rebuild, shall be applied first toward the satisfaction of any
existing defaults under the terms of this contract, and then as a prepayment upon the principal
balance owing. No such prepayment shall defer the time for payment of any remaining payments
required by said contract. Any surplus of said proceeds in excess of the balance owing hereon
shall be paid to the Purchaser,
9.
DEFAULT
If the Purchaser shall fail to perform any of the covenants or conditions contained in this
contract on or before the date on which the performance is required, the Seller shall give
Purchaser notice of default or performance, stating the Purchaser is allowed fourteen (14) days
from the date of the Notice to cure the default or performance. In the event the default or failure
of performance is not cured within the 14 day time period, then Seller shall have any of the
following remedies, in the discretion of Seller:
(a) give the Purchaser a written notice specifying the failure to cure the default and
informing the Purchaser that if the default continues for a period of an additional fifteen
(15) days after service of the notice of failure to cure, that without further notice, this
contract shall stand cancelled and Seller may regain possession of the property as provided
herein; or
(b) give the Purchaser a written notice specifying the failure to cure the default and
informing the Purchaser that if the default continues for a period of an additional fifteen
(15) days after service of the notice of failure to cure, that without further notice, the
entire principal balance and unpaid interest shall be immediately due and payable and
Seller may take appropriate action against Purchaser for collection of same according to
the laws of the .State of Nebraska.
In the event of default in any of the terms and conditions or installments due and payable
under the terms of this contract and Seller elects 9(a), Seller shall be entitled to immediate
possession of the property.
In the event of default and termination of the contract by Seller, Purchaser shall forfeit any
- 5-
Contract for Deed
and all payments made under the terms of this contract including taxes and assessments as
liquidated damages, Seller shall be entitled to recover such other damages as they maybe due
which are caused by the acts or negligence of Purchaser.
The parties expressly agree that in the event of default not cured by the Purchaser and
termination of this agreement, and Purchaser fails to vacate the premises, Seller shall have the
right to obtain possession by appropriate court action.
10.
DEED AND EVIDENCE OF TITLE
Upon total payment of the purchase price and any and all late charges, and other amounts
due Seller, Seller agrees to deliver to Purchaser a Warranty Deed to the subject property, at
Sellers expense, free and clear of any liens or encumbrances other than taxes and assessments for
the current year.
11.
NOTICES
All notices required hereunder shall be deemed to have been made when deposited in the
U. S. Mail, postage prepaid, certified, return receipt requested, to the Purchaser or Seller at the
addresses listed below. All notices required hereunder may he sent to:
Seller;
Kevin Christofferson
7428 Co. Rd. P35
Blair, NE 68008
Purchaser:
Chad M. Gibson
1952 Grant St.
Blair, NE 68008
and when mailed, postage prepaid, to said address, shall be binding and conclusively presumed to
be served upon said parties respectively.
- 6-
Contract for Deed
12.
ASSIGNMENT OR SALE
Purchaser shall not sell, assign, transfer or convey any interest in the subject property or
this agreement, without first securing the written consent of the Seller.
13.
PREPAYMENT
Purchaser to have the right to prepay, without penalty, the whole or any part of the
balance remaining unpaid on this contract at any time before the due date.
14.
ATTORNEY FEES
In the event of default, Purchaser shall pay to Seller, Seller's reasonable and actual
attorneys' fees and expenses incurred by Seller in enforcement of any rights of Seller. All attorney
fees shall be payable prior to Purchaser's being deemed to have corrected any such default.
15.
LATE PAYMENT CHARGES
If Purchaser shall fail to pay, within fifteen (15) days after due date, any installment
due hereunder, Purchaser shall be required to pay an additional charge of five (5%) percent
of the late installment. Such charge shall be paid to Seller at the time of payment of the past
due installment.
lb.
CONVEYANCE OR MORTGAGE BY SELLER
If the Seller's interest is now or hereafter encumbered by mortgage, the Seller covenants
that Seller will meet the payments of principal and interest thereon as they mature and produce
evidence thereof to the Purchaser upon demand. In the event the Seller shall default upon any
such mortgage or land contract, the Purchaser shall have the right to do the acts or make the
payments necessary to cure such default and shall be reimbursed for so doing by receiving,
- 7-
Contract for Deed
automatically, credit to this contract to apply on the payments due or to become due hereon.
The Seller reserves the right to convey, his or her interest in the above described land and
such conveyance hereof shall not be a cause for rescission but such conveyance shall be subject to
the terms of this agreement.
The Seller may, during the lifetime of this contract, place a mortgage on the premises
above described, which shall be a lien on the premises, saperior to the rights of the Purchaser
herein, or may continue and renew any existing mortgage thereon, provided that the aggregate
amount due on all outstanding mortgages shall not at any time be greater than the unpaid balance
of the contract.
17.
lENTIItE AGREIEiVIENT
This Agreement embodies and constitutes the entire understanding between the
parties with respect to the transactions contemplated herein. All prior or contemporaneous
agreements, understandings, representations, oral or written, are merged into this
Agreement.
18.
AMENi)MENT' -WAIVERS
This Agreement shall not be modified, or amended except by an instrument in writing
signed by all parties.
No delay or failure on the part of any party hereto in exercising any right, power or
privilege under this Agreement or under any other documents furnished in connection with or
pursuant to this Agreement shall impair any such right, power or privilege or be construed as a
waiver of any default or any acquiescence therein. No single or partial exercise of any such right,
power or privilege shall preclude the further exercise of such right, power or privilege, or the
exercise of any other right, power or privilege. No waiver shall be valid against any party hereto
unless made in writing and signed by the party against whom enforcement of such waiver is
sought and then only to the extent expressly specified therein.
- 8-
Contract for Deed
19.
SEVERABII,TTY
If any one or more of the provisions contained in this Agreement shall beheld illegal or
unenforceable by a court, no other provisions shall be affected by this holding. The parties intend
that in the event one or more provisions of this agreement are declared invalid or unenforceable,
the remaining provisions shall remain enforceable and this agreement shall be interpreted by a
~.
Court in favor of survival of all remaining provisions
20,
HEADINGS
Section headings contained in this Agreement are inserted for convenience of reference
only, shall not be deemed to be a part of this Agreement for any purpose, and shall not in any way
define or affect the meaning, construction or scope of any of the provisions hereof.
21.
PRONOUNS
All pronouns and any variations thereof shall be deemed- to refer to the masculine,
feminine, neuter, singular, or plural, as the identity of the person or entity may require. As used in
this agreement: (1) words of the masculine gender shall mean and include corresponding neuter
words or words of the feminine gender, (2) words in the singular shall mean and include the plural
and vice versa, and (3) the word "may" gives sole discretion without any obligation to take any
action.
22.
JOINT AND SEVERAL-LIABILITY
All Purchasers, if more than one, covenants and agrees that their obligations and liability
shall be joint and several.
- 9-
Contract for Deed
23.
PURCRASER'S RIGHT TO REINSTATE AFTER ACCELERATION
If Purchaser defaults and the loan is accelerated, then Purchaser shall have the right of
reinstatement as allowed under the laws of the State of Nebraska, provided that Purchaser: (a)
pays Lender all sums which then would be due under this agreement as if no acceleration had
occurred; (b) cures any default of any other covenants or agreements; and (c) pays all expenses
incurred in enforcing this agreement, including, but not limited to, reasonable attorneys' fees, and
other fees incurred for the purpose of protecting Seller's interest in the Property and rights under
this agreement. Seller may require that Purchaser pay such reinstatement sums and expenses in
one or more of the following forms, as selected by Seller: (a) cash, (b) money order, (c) certified
check, bank check, treasurer's check or cashier's cheek, provided any such cheek is drawn upon
an institution whose deposits are insured by a federal agency, instrumentality or entity or (d)
Electronic Funds Transfer. Upon reinstatement by Purchaser, this Security Instrument and
obligations secured hereby shall remain fully effective as if no acceleration had occurred.
24.
HEIILS AND ASSIGNS
This contract shall be binding upon and to the benefit of the heirs, administrators,
executors; and assigns of the parties hereto. However, nothing herein shall authorize a transfer in
violation of paragraph (12).
25.
()TREK. P,ROYIST~NS
- 10-
Contract for Deed
WITNESS THE SIGNATURES of the Parties this the 5th day of August, 2003.
SELL
'~ ~ - - PUR SE
~
Kevin R. Christofferson Chad M. Gibson
STATE OF NEBRASKA
COUNTY OF Washin~,ton
The foregoing instrument was acknowledged before me this 5~' day of August, 2003, by
Kevin R. Christofferson.
- ~l.C.{ ~ ~,Q
Printed Name: Carol B. Peters
My Commission expires:
July 30, 2006 - -
6ENERAL NOiAtll:`Shte ~ Nb4Cuka '
CAROL B. RETERS
My Comm. Fxp. Jury 30, 2006
STATE OF NEBRASKA
COUNTY OF Washington
The foregoing instrument was acknowledged before me this 5~` day of August, 2003, by
Chad M. Gibson.
~~ ,~ /`~ per,
Printed Name: Carol B. Peters
My Commission expires:
July 3 0. 2006
CE~RAL MOT~~S~tr~f N~tiruka
CAROL 8. PEAS
AH ~mrt~,:Fi~. hdy 30, 2006..
Seller(s) Name and Address Buyer(s~-Name and Address
Name: Kevin R. Christofferson Name: Cbad 1VI. Gibson
Address: 7428 Co. Rd. P35 Addr-ess: 2226 Clark St.
City: Blair City: Blair
State: NE Zip: b8008 Sta€e: NE Zip:68008
Phone: 402-426-4938 Phone: 402-306-2185
- 11-
~viiu ac;~ for Leea
CITY OF BI,t1IR
y ~,~
.O~o~iSe f a J~\` .
0
HOMEOWNER VERIFICATION FOR PLUMBING AND/OR
MECHANICAL PERMITS
~~C;~ ~ " ~ ~ v 1~~~
'nt your full name online above:
states the following:
1. I am the owner of the single family dwelling for which I am applying for a
plumbing and/or mechanical permit.
Address: ~: l ~~~ ~~avl.~ 5't
2. I am applying for a plumbing and/or mechanical permit for a single family
dwelling and it is or will be my principal residence.
3. I will install and connect the plumbing and/or mechanical by myself, without
compensation or pay from or to, any other person.
4. I have sufficient knowledge of the 2003 International Code requirements to make
an electrically safe and mechanically secure installation, which will meet the
minimum standards referenced in the 2003 International Code.
5. I am aware of all inspections required prior to a final.
6. I will call twenty-four (24) hours in advance for an inspection. I am also aware
that it is not the inspector's job or duty to be my instructor in plumbing and/or
mechanical.
7. I am aware that violation of the code makes it a Class 1 misdemeanor to make a
false statement on a request for inspection.
8. By signing this form I am stating the above information is true an correct.
Date
~~
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cilyofblair@huntel.net „~,~°
CITY OF BLAIR
Application for Building Permit
pram pr.n ~T
Address ~~5~ ~~'~~"~'~
Date Co~ f -~~
Legal Description: Lot 1 Block. fob Addition ~~G~-"~`
Please show all measurements of existing and contemplated structures,
also show distances between structures, etc,, and property lines,
Is this a corner lot? n
fi
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a
s~
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Cent e
Ind:eate- North
. _,
Applicant ~~
CITY OF BI,t\IR
Ar~
o~~se of
BUILDING PERMIT DEPOSIT AGREEMENT
A $200.00 refundable deposit is being collected .at the time of your building permit
application for all permits $10,0000 and above. However, the City reserves the right
to not refund this deposit if any of the following conditions occur during the
construction period: 1) theft of water service by either the plumber, owner or general
_ contractor, 2) .all required inspections. have not been. obtained, 3) .occupancy occurs _ - -. .-
°.., .-.°.......,.° .~ tor-to a final7ns action°°~)-alfi rmits h~s~~ot been obtained; ands ~h~ ro~eofi is,. °.-~.._.._._.~:~_ ..,..; _
completed without a final inspection being done. If any or all of these situations
occur during construction, you may forfeit your deposit.
I, hereby agree to the above conditions, and understand that should any or all of the
above situations occur, the building permit deposit SHALL be forfeited or discounted
upon the discretion of the City of Blair, Building and Inspections Department.
Contractor/Owner
~e~ ' ~-a~
C ntract caner
City of Blair
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel.net ,~n.,n
CITY OF BId1Il2
'br,~_
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-~distrib~fted-~to -aid you- in~-~our ~bi~ilding pe~°rifprocess: -• ~A•-cc~py~>~~-tli~ ~_. °. _ . ,:
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/Oc upant
City of Blair
Contractor
(J ~~/
Date
/\
218 South 1 bth Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel,net
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