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BP10616City of Blair Building Permit Detail Permit #: 10616 Issued: 06/28/2004 Completed: 01 /05/2006 Location: 2120 Jackson Street Owner: Crystal Vogt Address: 2120 Jackson Street Type: Roofing permits -All types Valuation: 4894 Blair, NE 68008 Phone: 402 426 8736 Section: Township: Range: Subdivision: Lot: Tearing off one layer and replacing with asphalt shingles. Replacing all gutters. Contractors Home Pride Companies, Inc. General Contractor Remarks 01/05/2006 STATUS No final was done. Permit Fee: 15 Issue Fee: Deposit Amt.: Receipt #: Block: Permit # Issued Inspections Date By ~~ BUILDING PERMIT APPLI ~~ Jurisdiction of City of Blair, Nebraska Permit Fee: 218 South 16th Street Issuance Fee: Blair, Nebraska 68008 Receipt #: (402) 426-4191 • Fax (402) 426-4195 Deposit Receipt #• Permit 10616 Issue Date: ~ ~~ ~'~Uy Type: ~ ~/~ r ~~1.~ JOB ADDRESS alga Yh LEGAL 1 . DESCR. ^ SEE ATTACHED SHEET 2 OWNER ~ (, MAILADDRESS Zlp HOME PHONE (f~ ~~ ~ ~~~ WORK/CELL PHONE `~ 3. CO~ ~ ~ ~~ U ~ ~r ~ i~ MAILADDRES~ I y ZIP yyDRKICEOLL PHONE ,J~fa "~,5~ 4. Class of Work: Q NEW Q ADDITION Q REMODEL Q OTHER o FINISHED BASEMENT ~ UNFINISHED BASEMENT 5. Describe Work: rR'~- ~ ~ ~ \ c~ v 6. Valuation of Work: $ ~ ~]y Total Sq. Footage (IRCIudiRg Basement and Garages: Total Finished Area: Floodway Q Yes 7. FIOOdplain: Fringe ^ Yes O No Dev. Permit ^ No BFE Elev. Cert. 8. Current Zoning: 9. State Fire Marshall Required: Q Yes 10. Special Use Permit Required: Q Yes 11. Variance Required; Q Yes Q No Q No Q 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 acknowledge that 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 specif ications 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 days or is not complete within 2 years of date of issue. SIGNATURE OF OWNERICONTRACTOR DATE Comment: Q Site Plan Attached ~ 0(t~p~ ~e Plans Attached Approximate Completion Date Inspections Required and Fees Utilities Sewer Water Service_ Septic Remote Stop Box Card Building Footings Framing Electrical Rough-in Final Temporary Service Mechanical _ Rough-in Final Plumbing Ground Work Rough-in Drywall (PRIOR TO TAPING) Final Fixtures Permanent Service A\C Final WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Approved By: I ,/~ ~ ,. ~ J do CAT I ®N~ -~ o~~ Rev. Bl96 POUNDS PRIG.-Blair, NE