BPM1670
Permit #: M1670 Issued:
Completed:
Location: 11096 Co Rd P29
Owner: Andrea Dickerson
Address: 11096 Co Rd P29
Blair, NE 68008
Phone: 426 9656
Section:
Subdivision:
Heat Pump & Coil Replacement
Township:
Contractors
Service One
Remarks
Inspections Date
9/10/2008
9/10/2008
By
DEM
DEM
Blair Building Permit Detail
8/28/2008
9/10/2008
Range:
Lot:
Type: Mechanical Miscellaneous
Valuation:
General Contractor
Mechanical Final
Final Inspection of Project
Permit Fee: 10
Issue Fee: 20
Deposit Amt.:
Receipt #:
Block:
Permit #
Issued
Pass
Pass
I'
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:
Job Address
Owner
1.
2.
3. Class of Wark:
Describe Work:
4.
Central AlC
Tons
Furnace
BTUIH
AlC
# of Units
Furnace
Completion Date:
Comments:
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
Signature of Contractor or Authorized Agent
Date
M 1670
7
Forced Air/Heat Pump Systems - Per Unit
Commercial/Residential (New)............ ......................... ....$25.00
Air-Conditioner Unit - Per Unit
Commercial/Residential (New)..
!IJ,()O
.................. ...$1 0.00
Forced Air Systems/Air Conditioner
Unit Replacement Per Unit Commercial/ResidentiaL.. ... ... ... ... ..$10.00
Refrigeration Units/Coolers/Lines/Compressor -
Per Unit Commercial (New or Replacement)... ... ... ... ... ... ... ... ..$10.00
Appliance Vent/Fans... ...... ... ... ... .. ...$10.00
Boiler... ... ... ... ... .. . ... ... ... ... ... ... .. ...$15.00
Duct System................................ .$10.00
Gas/Air Outlets.......................
x $2.00
Radiant Heat Systems/Gas/Water
Piping System......... ................... ...$25.00
Modular Home... ... ... ...... . .. ... ... ... ... $50.00
Permit Issuance Fee... ...... ......... ...... $20.00
Total
v
Current License on File ~s 0 No
o NjA
Comment:
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: ~ff~/cfi~
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1670
(402) 426-4191
Application Date:
Job Address
Contractor
2.
3. Class of Work:
Describe Work:
4.
Central AIC
Tons
Fumace
BTU/H
AlC
# of Units
Furnace
Completion Date: __
Comments:
Notice
I hereby certify that I have read and examined this
application and know the same to bc true and conect. Ail
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein 01'
not. The granting of a permit does not presume to give
authority to violate 01' cancel the provisions of any other
state or local law regulating construction or the
pelformance
::.1 00
Permit Fee: $ L)O (
Phone . ,
- r {c/o (;;?
j Phone
chn a/7 t'A.- if; fJ 1;1
o Repair 0 Replacement
W#I1tJW'1o-
NICAL PERMIT FEES
Forced Air/Heat Pump Systems - Per Unit
Commercial/Residential (New)... ............... ... ... .... ........ .....$25.00
Air-Conditioner Unit - Per Unit Z cJ, 10, 0 c>
Commercial/Residential (New). .f'!!.. .'.'1M!!/!.................. ....$10.00
Forced Air Systems/Air Conditioner
Unit Replacement Per Unit CommerciallResidential.............. ...$10.00
Refrigeration Units/Coolers/Lines/Compressor -
Per Unit Commercial (New or Replacement)........................ ..$10.00
Appliance Vent/Fans..................... ..$10.00
Boiler...................................... ...$15.00
Duct System... ... ... ......... ... ......... ...$10.00
Gasl Air Outlets.......................
x $2.00
Radiant Heat Systems/Gas/W ater
Piping System............................ ...$25.00
Modular Home...........,............... ... $50.00
Permit Issuance Fee... ............ ... .... ..$20.00
Total
o<t/. 00
tic?
Current License on File ~s 0 No
o N/A
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: !if. 0/~
RECEIVED AUG 29 Z008
k"-~"~ ""'''~'-''''-'''~'-"''''7C''''''''-:::~--=~'''''''''''''-~'~~~~''''''''''''''''''-''-~--;-7'~,::..~,_.~.,.~",...._~~~..~..~.-~~.--".".".,.,...:"""'''_,..,..._._,...
BUIEpING INSPECTION REPORT
~-:-::-~'~~'''''''''''~~''-~
.. .- ....- ,"_... --..
B:::'CITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
il. ':;-./, ,I 'J"/ /
// C) II (.?' (O 1<-c7
)-4 / 0 ~.-';:7'
Li-".;;~ib' ~., /6z:;x.(/
! CONTRACTOR-
LOCATION OF INSPECTION'
Z /. 1\' LA
NAME OF OWNER" ~r<Jl c;bU ";':0 -I:...J J (lIfJ'-'(..() OT)
DATE INSPECTION REQUESTED' Cl-. I 0 - Li3
t/'70.
! co' I
S'l. '"
'-::- jd II ,I (;p
('/~'1' ,1
,~" n.J::,.,<
/1) . <,' F'{ .t1. ,V
TIME INSPECTION REQUESTED- u' e,)G.. ,{ ; ,. PERMIT NO'
f1/~1 76
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE 0 STATUS CHECK
~~Z:-.- """"~,=",.- --:l.~-';'r""r'''''''''''''''''''' :t1'i.1!P'~_'T~_'::~~~~.!:::Z4-~~~~
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 'ISl",F.INAL 0 PARTIAL P~D F~ED
COMMENTS: ~
~...Jr"'"'~~~"='&~~.z..~~~"""""""'~~~~~~~-==
UTILITIES: 0 SEWER TAP; 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATERSERVICE
o PARTIAL
PLUMBING:
o GROUNDWORK D' ROtJGH~1N D FINAL
o PRESSURE TEST
PASSED FAILED
0 0
PASSED FAILED
0 0
PT FAILED
D
PASSED FAILED '
0 0
COMMENTS:
ELECTRICAL: 0
o
IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
PARTIAL
COMMENTS:
MECHANICAL:
ROUGH-IN 0 AlC 0 FURNACE 0 RADIANTHEAT'';:Q:''FINAL 0 PARTIAL
!
COMMENT~:
',." -'- '........ .. . ".. .
~~~~~~~~~~~~
':""
'.:
.;;
",
'.~' ,.:., . .'. - .
. <. "'.: ". ':', ',' " ".
'" ',..'..' :~.-:> .:~" "., .... '. ,':' . ~,(
, . ' ":" _ '.... c~ i-' .. . c c;: .' " . :,:
.. . ' . . ..... . "'. . .' .:c __ '..:.., . . " . _ .' . .':.";. .:
.' ',-,',' .. '...''-" ~..'..".:"c'.,. .,..----- ", ". " . ..,... '.: ',' .,".,.....~(.,<
'.' ", ',', , ." ..'>~; ';. ~. H'. j- '.' '. ", "', ..... ". " . ~'.__ '. >,'. ...... .'. ...:,c,'>:
,.",.. "-'."';':.;':"'" ,":,).:,.". 'l;:'.~/' '.c.,':. .-'~, . .c;,._.. /'.':....c: "":"'C~"'I"
",.'" . ...::, .j. 'c. '. ,<.';.'" . :,...(,.'" ,......-'. .....f". -:."l'-'-, ..;:\ ,,'_.";.X,.-:-: ;..'
FY,:; /. >' '1;)~< ",).L;.-, '.' ,',..,, .' j,.;'j .' 1,/,;":',,
;=~;,;.' ....~:.-'Ar~ /[, '," ". .-(t--,,'-, '. / Ull'/'r, >/))>:'If'
. y# <;.. . "., [)-p"l '" :..hI,
.' '..... C-'" :--. ".:....,.. ,..~ ....'., ~,. .'} '~,.;: .' ",-'.' ' ",.." "_". L :<.. ...,..'.- 'I,:: :,,--'": ',......,.,". :--.' . "_;~
. N" i,~" f.:." '~':;'.- .. ,..,;-; .":,,-, .... .... "":""" ..'
'.'-: ::~'_;',~ __".' .;c ":",.,. ~~ ::;'. '''' _ '. ";..,;- ,.' .-,c .:< ....,.?:.;-'-').,,~. ".; ;~,:.." .:..-.:; :..:.;;:r;..,:'~
;~;.: c.:. '~,-, .:_;'.''-:::;:-' c' ."" ,c "',',:>;;'
'...' :,,' '.-. ","C -.C,'.' ',", "'.'-c; ,,-.,., '~:.c" ':;.'. ,.;>' ,'. --,-'.- .; ':C;,~'--,
,..
I
I
/
.
1,....,.----
)
)
)
-
~
..
3
::>
..J
,..
l...
u
,
I
-
"
.
7
-
.
\l
, \1\
\ \'\
,... I
. . ,\
, . II
. , ~l
, , 11