BP11214City of Blair Building Permit Detail
Permit #: 11214 Issued: 08/03/2004
Completed: 01 /04/2006
Location: 625 S. 17th Street
Owner: Lynette Jones
Address: 625 S. 17th Street
Type: Roofing permits -All types
Valuation: 3292
Blair, NE 68008
Phone:
Section: Township: Range:
Subdivision: Lot:
Tear off one layer and replace with asphalt
Contractors
Jensen Bros. Roofing Specialists 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
S~ Jurisdiction of City of Blair, Nebraska
Permit Fee'
Issuance Fee:
Receipt #:
Deposit Receipt #:
Issue Date:
218 South 16th Street
Blair, Nebraska 68008 1 1214
(402) 426-4191 • Fax (402) 426-4195 Permit
Type:
JOB ADDRESS ~ ~ ~ 1 n / ~ ~
d
LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
OWNER ~
2, MAIL ADDRESS ZIP HOME PHONE
WORKICELL PHONE
CO TOR
3, I j~W'~ ~ MAIL ADDRESS ZIP HOME PHONE
WORK/CELL PHONE
4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL ^ OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT
5. Describe Work~,~ ~Y-~ ~,,,~ ~
6. Valuation of Work: $ 7j- ~, ~ ~ Total Sq. Footage Qrtcl~airtg Basement ana Garage): Total Finished Area:
Floodway ^ Yes O No
7. Floodplain: Fringe Q Yes ~ No Dev. Permit
BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes ^ No
10. Special Use Permit Required: ^ Yes ^ No.
11. Variance Required: ^ Yes ^ No
12. Minimum Setbacks: Front Side Rear
13. Sidewalk Required: ^ Yes ^ 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 furtheragree 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 ac ordance with the codes/ordinances of the City of Blair and the
State ofNebras der a d hispermitisvoidifworkisnotcommencedwithin
180 days or ' no o~~ 'ti5n 2 years of date of issue. ,
^ Site Plan Attached ^ Complete Plans Attached
Approximate Completion Date
Inspections
il' i Required and Fees
Sewer Water Service
Septic Remote
Stop Box Card
it in
Footings Drywall
(PRIOR TO TAPING)
Framing Final
Electrical
Rough-in
Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A\C ,
Final
PI m in
Ground Work
Rough-in Final
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: „
~~
POUNDS PRTG.-Bleir, NE 1 ~ Rte' ~
J ~ CI'T~" OF BI,~~IR
..~ v
y _~ - ~~
,`
-b~o~/se of a Jd~~
ROOFING PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and/or roofing permit requirements. It in no way includes p:LL 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.
l have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the c -
Owner/Occupant
City of Blair
218 South.l6th Street • Blair, Nebraska 68008 •-402-426-4191 • Fax 402-426-4195 E-mail cityofblair@ci.blair.ne,us e:o•,r•.,..
Date