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BP12217City of Blair Building Permit Detail Permit #: 12217 Issued: 08/09/2005 Type: Roofing permits -All types Completed: 01/04/2006 Valuation; 62500 Location: 2242 Wright Street Owner: Good Shepherd/ Johansen Manor etc. Address: 2242 Wright Street Blair, NE 68008 Phone: 402 426 4663 Section: Township: Range: Subdivision: Lot: Tearing off one layer and replacing with asphalt on all buildings. Contractors Dave's Roofing General Contractor Remarks 01/04/2006 STATUS No final was done. Permit Fee: 15 Issue Fee: Deposit Amt.: Receipt #: Block: Permit # Issued Inspections Date By BUILDING PERMIT APPLICATION . h visdiMinn of CiN of Rlair Nwhraaka Jurlsdtctlon of Clty of Blatr, Nebraska Permit Fee: /~ ~ U 218 South 16th Street Issuance Fee: Blair, Nebraska 68008 12 217 Receipt #: (402) 426-4191 • Fax (402) 426-4195 Permit Deposit Receipt #: Issue Date: ~'" ~'~6~~~ Type: ~ ~ JOB ADDRESS ^~ r ~ , J,/ p'~/ LEGAL 1 . DESCR. Q SEE ATTACHED SHEET 2.OW lfi / ~,/ CC~~ / ~~ ~,~,~ / /~L~~~~//LADDR SS «// ~ ZIP WORKICELLPHONE p?~'~~ CONT CTOR '3, ~ MAIL A , ~ S ~~~/ A ~~~~ Z~ ~~~ ~ HOME PHONE ~~ ~ ~/~~ , dI~ WORK/CELL PHONE !T/~ 4. Class of Work: NEW Q DDITION Q REMODEL Q OTHER Q FINISHED BASEMENT Q UNFINISHED BASEMENT 5. Describe Work: ~ ~~ ~~ ~~~ ~ Gc~ 6. Valuation of Work: $ ~ JrDO• ~ d Total Sq. Footage (Inoluaing easement ana Garage): Total Finished Area: Floodway ^ Yes ^ No Dev. Permit 7. Floodplaln: Fringe ^ Yes ^ No BFE Elev. Cert. 8. Current Zoning: 9. State Fire Marshall Required: Q Yes Q No 10. Special Use Permit Required: Q Yes Q No. 11. Variance Required: Q Yes Q No 12. Minimum Setbacks: -Front 13. Sidewalk Required: Q Yes Side Rear Q 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 bythis 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 ofNebraska.lunderstandthatthispermiti voidifworkisnotcommencedwithin 180 day not complete thin 2 y a~r o date of issue. SIGNATURE OF Comment: T_ DATE Q Site Plan Attached y C m lete~lans ttached Approximate Completion Date ~~ ~~~ "~~Q~ Inspections Required and Fees Utilities Sewer Septic _ in Footings Water Service Remote Stop Box Card Framing E c ri Rough-in Final Drywall (PRIOR TO TAPING) Final Temporary Service ni I Rough-in _ Final in - Ground Work Rough-in _ Fixtures Permanent Service A\C , Final WHEN PROPERLY VALIDATED IN THIS Approved By: j /J THIS IS YOUR PERMIT Rev. 8/96 POUNDS PRIG: Blair, NE CITY OF BI~~~IR aro~~se ~ ,t a~a~~ 0 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 buildyng permit documentation on my own behalf assuming full responsibility as the owner/contractor for this project. OwneNOccupant City of Blair ~_ ~- ~~ Date 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mall cityofblair@cl.blair.ne.us