BP12514~k X31 ~~~ CK.~ 10 31
Blair Building Permit Detail
Permit #: 12514 Issued: 7/12/2006 Type: Ag Barn
Completed: 8/8/2006 Valuation: 15000
Location: 12874 State Hwy 75
Owner: Curt Jensen Permit Fee: 75
Address: 12874 State Hwy 75 Issue Fee: 15
Deposit Amt.: 200
Blair, NE 68008 Receipt #: 17099
Phone: 402 426 9328
Section: Township: Range:
Subdivision: Lot: Block:
Farm Storage Shelter for Hay/Machinery 40'x66' steel frame building 15' walls and 1/12 pitch roof. No electric or
plumbing.
Contractors
Jorgensen Contracting, Inc. General Contractor Permit # Issued
Remarks
Inspections Date By
7/20/2006 KAR Footings Pass
8/8/2006 DEM Final Inspection of Project Pass
BUILDING PERMIT APPLICATION
~~' pC~ 9® p(j Jurisdiction of City of Blair, Nebraska
Permit Fee: ~p• 218 South 16th Street
Issuance Fee: ~J~• DD ,~dU• °~ Blair, Nebraska 68008 1 2 514
Receipt #: c~9~, ~d(402) 426-4191 • Fax (402) 426-4195 Permit
Deposit Receipt #: „ ,~
Issue Date: Type: c
JOB ADDRESS ~~ ,~, i /
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LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
OWN
2. ~ MAILADDRESS
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WORIVCELL PHONE /~ ry
7~` ~ ' ~~
q CONTRACTOR
a7. MA ADDRESS
~ ZIP HOME PHONE
v/Lid ~~,~° WORK/CELL PHONE
~~~ -7 / ~(~'
4. Class of Work: ^ NEW ^ ADDITIO
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Q REMO
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^ OTHER Q F
IN
ISHED BASEMENT ^ UNFINIS
H
ED
BASEMENT
5. Describe Work: ~~ ~ ///
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6. Valuation of Work: $~~'pp~, ~~ Total Sq. Footage (IRCluaingBa6ementanaGarage): Total Finished Area:
Floodway Q Yes ^ No
7. Floodplain: Fringe Q Yes Q No Dev. Permit
BFE Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes [~No
10. Special Use Permit Required: Q Yes ~No
11. Variance Required: ^ Yes ~No
12. Minimum Setbacks: Front. Side ~ Rear ~~~
13. Sidewalk Required: Q Yes 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 acknowledgethat payment
of the building permit application fee does not constitute issuance of this building
permit. I furtheragree that construction covered bythis permitapplication 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 ifwork is not commenced within
80 ays or is not complete thin 2 years of date of issuer
7-~-010
DATE
Comment: r ~ u
' MEETIBC, IRC, ~C, IMCANQNECCODEREQUIREMENTS
Q Site Plan Attached ~~
C9~pl~ Plans Attached
Approximate Completion Date ~
7
//
Inspections
ili i Required and Fees
Sewer Water Service
Septic Remote
Stop Box Card
Bilin
Foo ' gs Drywall
(PRIOR TAPING)
Framing Fi
EI ri al
Rough-in Fixtures
Final Permanent Service
Temporary Service
Mechanical
Rough-in A\C ,
Final
Plumbing -
Ground Work
Rough-in
Final
WHEN PROPERLY VALIDATE611N T-YiIS SPACEI THIS IS
Rev. 8/96
POUNDS PRIG: Blair, NE
BUILDING INSPECTION REPORT
.~TI'Y 0~' BLAIR ^ WASHWGTON COUNTY ^ OTHER
LOCATION OFINSPECTION• ~~U /7 U~G~(/ ~~G,~
NAME OF OWNER ~/ ~ i~/eirlQ~ rnNTRer~rnu• l Jim/ D.,~~~.~-~
DATE INSPECTION RE UESTED• J
Q ~ ~ ~~ TIME INSPECTION REQUESTED ,~ 7 PERMIT NO• /a
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CAECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL INAL ^ PARTIAL PASS FAILED
COMMENTS: ~~~ ,COQ, ~~ , / _ j~,~- ~ ^
UTILTI'IES: ^ SEWER TAP '^ SEWER ^ SEPTIC ^ WATER TAP ^ MOTE ^ WATER SERVI/C(E/O ~fr"i' PASSED FAILED
COMMENTS: ^ PARTIAL ^ ^
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED 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
COMMENTS: ^ PRESSURE TEST ^ ^
^ .OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
!~ f
OF INSPECTION MADE: ~ T~• ~~~U
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON By
BUILDING INSPECTION REPORT
TI'Y OF,~LAIR ^ WASHINGTON COUNTY Q ~/ [~^ OTHE(~R1 `~ r~
LOCATION OF INSPECTION: ~~ 8 ! 7 C 1 T ~ ~! ~Gl /
NAME OF OWNER: ~ G~iI ~ C~~~~ CONTRALTO ~ ~~I ~Gt ~~~
DATE INSPECTION REQUESTED: ~~ Or ~ ~Q lam' TIME INSPECTION REQUESTED: ~D'~DD A' ~' PERMTI' N0: ~a~~7
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUII.DING: FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL
COMMENTS: ~`2/f/jj'I 77l/ a /~~,,,~ P SS AILED
^
UTILTTIES: ^ SEWER TAP ^ SEWER SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE
^ PARTIAL >
COMMENTS: PASSED FAILED
^ ^
ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT
^ PARTIAL
COMMENTS: PASSED FAILED
^ ^
MECHANICAL: ^ ROUGYI-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL
COMMENTS: PASSED FAILED
^ ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL
^ PRESSURE TEST
COMMENTS: PASSED FAILED
^ ^
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS•
DATE OF INSPECTION MADE: ~` ~~` ~ T Q ` ~~
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON
CITY OF BZL~II~
,or~_
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
prior to a final inspection, 4) all permits have not been obtained, and 5) the project 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 forteited or discounted
upon the discretion of the City of Blair, Building and Inspections Department.
~ntractor/Owner
Ci#y of Blair
~- ~ a - ~ -~
Date
/\
_~
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel.net ~~°
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