BP13054
Permit #: 13054 Issued:
Completed:
Location: 1338 Nebraska St
Owner: Grace Wolf
Address: 815 Gottsch Dr
Arlington, NE 68002
Phone: 4024784508
Section:
Subdivision:
Township:
-"",,!llIIdtil1l<"
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Blair Building Permit Detail
09/01/2008
11/25/2009
Type: Residential - New Construction
Valuation: 176700
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
989.52
20
500
23082
Range:
Lot: 9
Block: 7
2 BR Ranch with unfinished basement - bathroom will be finished in the basement. 1 Car attached garage. Have
BOND Check for 432.00. Sent check back 10/21/2008.
Contractors
Paul D. Anderson Construction
Chapman Mechanical Services Co. Inc.
Chapman Mechanical Services Co. Inc.
Henton Trenching, Inc.
MAC.S. Electric
Remarks
10/14/2008 BMP
04/23/2009 KAR
07/09/2009 BMP
General Contractor
Heating Subcontractor
Plumbing Subcontractor
Plumbing Subcontractor
Electrical Subcontractor
Permit #
M1802
P1964
P1940
E3018
Issued
12/03/2008
12/03/2008
10/07/2008
10/09/2008
Have Bond check for 432.00 from Henton Trenching. They will need to cut street for sewer
service.
Sink is wired wrong not neat reversed. top side for dishwasher plug. Bottom side for
dispenser open neutral. Code requires, duct work to have all seams sealed. Ladder required
for egress window well post address on fron of house 30 days.
Not ready for a final yet changed completion date to 9-30-2009
11/11/2009 HOW 1. needs elect final call for elect insp.
2. provide handrail return and proper diameter forgripping.
Inspections Date By
09/19/2008 OEM Footings Pass
1 % 1 /2008 DE~v1 Footings Pass
10/06/2008 OEM Electrical Temporary Service Pass
10/08/2008 OEM Sewer Lines Pass
10/08/2008 OEM Water Service Pass
10/21/2008 MARH Final Inspection of Project Pass Partial
12/04/2008 OEM Plumbing Groundwork Pass
12/16/2008 OEM Electrical Permanent Service Pass
01/09/2009 OEM Electrical Rough-ins Pass
01/19/2009 OEM Plumbing Rough-ins Fail
01/19/2009 OEM Mechanical Rough-ins Pass
01/19/2009 OEM Plumbing Pressure Test Fail
Blair Building Permit Detail
01/19/2009 OEM Framing Fail
01/21/2009 OEM Plumbing Groundwork Pass
01/21/2009 OEM Plumbing Pressure Test Pass
04/23/2009 KAR Final Inspection of Project Fail
04/23/2009 KAR Electrical Final Fail
04/23/2009 KAR Mechanical Final Pass
04/23/2009 KAR Plumbing Final Pass
OS/22/2009 SAJ Stop Box Card Pass
11/11/2009 HOW Final Inspection of Project Pass
11/25/2009 KAR Electrical Final Pass
, !':
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT 2r';
Permit #\ ~J.-')S~
Date: 1; Approximate Completion Date: 3) 3\ \ OLl
Site Plan Attached~ REsch1eck Attach~omPlele Plans Attached
Application for: Reslde'tl)ill ~ ~mmercialjlnduslrial
New Construction -L Manufactured Home _ Modular_
Move-on: Home _ Accessory Building Other
Remodel Addition
Accessory Building: Garage _ Pole Barn_ Other
Floor Type: Dirt Concrete Electricity: Yes _ No
Other
Utilities: Public Water: Yes_ No Private Well
If yes, responsible entity: Blair OPPD Line Kennard
Agreement needed: _ Date Agreement Received: _
Public Sewer: Yes_ No Septic Drawing Provided: _
If yes, responsible entity: Blair _ Kennard_
County Road Permit Required: Yes_ No _ Submitted: Yes _ No _
lD lln f7 n ISl<J2l
- r (L CAL (:[(:,i
Proiect Information:
Job Address: 133<6 Nc:bV"'{).s ~ ,S+ 8900 Lf2ZZIj./
Legal Description (if applicable) ${! ,:?lof.- c:t ~ ;1>1 o;! tI/f~~ Slj.13}16 '/
owner:lJ(~(lfll:~-, \NO\ ~ Address:.815 .Loo-\+SCh1Ji ~~~l~:n '-/7fL/;rsv ~
Contractor: PCtuJ A:VlCLiVSrH0 r~tvLlGhun Phone#: 4&(y.~5?SID
~Ole 16YCL~ 0J-)\J. M-
Address:
Cell #:
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic systems. By my signature
below, I acknowledge this building permit application 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 a permit 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
cOdesjordinancesof the City of ~'. ir and.the State of Nebraska. I understand that this permit is VO.id if work is n.ot commenced within
"~Y'''' "" oom " Ith; two ,?Y"~ old"""".., 4 ~ d
~~. . / .,' //' . ..... tJ''O
sigrfafu of Owner/Contractor / Date
(
ZONING REVIEW:
Zonin Flood Plain
Current Zoning:
Conditional Use Permit Required: Yes _ No
Date cuyproved:
Yes _ No' Variance Required: Yes _ No'
Second Front Side '~7 Side _ Rear
State Fire Marshal Required:
Minimum Setbacks: Front
Lot Square Footage:
Length x Width: I to''f. 150
_.
Lot Coverage %
Driveways/Sidewalks: !-'.
Sidewalk required: Yes No _ Sidewalk Waiver: Yes
* Date Waiver Approved:
Flood Plain: Yes No
If yes, specify sp~cial re irements:
No.:x-
BUILDING INSPECTOR REVIEW:
Number of Stories
,.,,,.
One '/' Two
...K.- _
Th ree
Four
>Four
High Rise (>75 ft)_
Type of Residential Structure:
Ranch V/ Two Story _ Split Entry _ Raised Ranch _ Other
Rooms _ Bedrooms ~ Bathrooms "J.- Fireplaces _ Gas_ Electric_
Egress in Basement: Required: Yes V"No _ Provided on Plans: Yes ~No
Sleeping Rooms Living Area Other Egress
Square Footage: /rJ-
Main Level: I L / ()
.
Basement: (Unfinished)
Garage: 4S~
Detached Garage:
Addition:
Porch: Front
Deck that affect setbacks:
Second Level:
/,L7{) (Finished)
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front
Third Level
Rear
Rear
Side
Occupancy Classification:
Assembly, theaters, with stage Assembly, theater, without stage _
Assembly, nightclubs _ Assembly, restaurants, bars, banquet halls_
Assembly, churches _ Assembly, arenas _
Assembly, general, community halls, IibrClries, museums _
Business Educational Factory and industrial, moderate hazard _
Factory and industrial, low hazard _ High Hazard, explosives _
High Hazard HPM Institutional, supervised environment _
Institutional, incapacitated _ Institutional, restrained - X
Institutional, day care facilities _ Mercantile _ Residential, hotels _
CITY OF BLAIR - MISCELLANEOUS BUILDING PERMIT
Permit #
Date:
.-1rt/OApproximate Completion Date:
Estimated Valuation of Project:
Site Plan Attached:
Application for:
Fee: $115.00
Permit Fee $40 + Issuance Fee $25 + $50 Deposit
Egress Window (floor plan drawing required)
Fences (plot plan required)
Gazebos (plot plan required)
Patios/Driveways/Sidewalks (new or replacement)
Roofing/Siding/Soffit and/or Eave Repair/Gutters
Swimming Pools with Fence (plot plan required)
Window/Door Replacement (size change only)
Miscellaneous Building Permits (items not covered by one of the above)
Description:
Utility Excavation and Curb Grinding
Curb Grind
Length
Utility Excavation
Length /.;)
Type: Water
Fee: $75 plus bond
~
Un. Ft.; Width
; Sewer
Un. Ft
00 ~'
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Un. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
Additio"~1 Pesc~~o" of p(oJect if ",;cessary: . '-IJ1Clbi! ta: i1t>O ~
(?I-.,1Llf: -z:;-P1 iJvtV \J~J vJM clncl /(;J",;~
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PROJECT INFORMATION:
Job Address:
/:?313 ;JU&C0t:.,Cl Jf.
Legal Description (if applicable)
Owner:
Address:
Phone#: t.(' 'l tJ .-
li/E
Phone #:
Contractor:
Address:
Cell #:
PERMIT RENEWAL FEE:
This fee is based on the amount of the original permit fee and is charged when work is not
completed within two years and the permit expires. Renewals will onlv be allowed with the
stipulation that all exterior site work and outside finish work is completed and interior life-
safety issues have been properly address. Permit renewals are for one (1) year, with a
maximum of two (2) renewals for a maximum permit span of four (4) years.
Original permit fee of $0-$50,000 $100.00 $
Original permit fee of $50,000 - $100,000 $150.00 $
Original permit fee of $100,000 - $500,000 $250.00 $
Original permit fee of $500,000 or more $400.00 $
Issuance Fee:
$
25.00
Deposit:
$
50.00
Total Renewal Remit Fee = Permit Fee + Deposit + Issuance Fee $
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic
systems. By my signature below, I acknowledge this building permit application 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 a permit 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 that this permit is void if work
is not commenced within 180 days or is not completed within two (2) years of date of issue.
/
I
.~'J G?)"-l,?'^'-'eL 'f,' I ,c) '7"_,-C.~/f'
{.
Signature of Owner/Contractor
Date
For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit paid:/O .-1.-0{3 Receipt # - Appr~v;d by:"f{. ;'?ff;J?~f~-
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair., NE 68008
t,
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
~
Application Date: /';;2 ~ 3 - 0 Z3
Job Address
Comments:
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions oflaws 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.
t"'-'
) ..1. 3- 0 if
Date
I
a
~lf?r.~
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( DO sLf
P 1964
IlJiJ Jot)
Permit Fee: $
Phone
/#d~)!!l. It;.u, ma0Phone
o Alteration 0 Repair 0 Replacement
/;J.OV
/;:J.O{.I
1) -(,10
!J;.oo
10.(;0
I;J.O{)
/5.00
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: o. n f
.1:) . iJ Jj/Ulhr
Jb Mia." Jf.
Zip
#dtJ #~
PLUMBING PERMIT FEES
Modular Home............ ....... ...$50.00
Type of Fixture No.
Kitchen............................ ..$12.00 x I
Bath... ..Residential/Single Stall $12.00 x ~
... ...... ........ ...Multi-Stall $25.00 x
Rough-In Bath.......... ...... ........$8.00 x~
Additional Sinks.................... .$6.00 x
Slop Sink/Laundry Tray/Drain.....$6.00 x ~
Water Heater... ...... ...... ... .......$10.00 x~
Outside Water Faucet...................$6.00 x ~
Drinking Fountain........................$6.00 x_
Backflow/Grease Trap....... .... ..$15.00
Water Service...................... .$15.00
Sewer.............................. ...$15.00
Groundwork.................... .....$15.00 ~
Septic Tank & Laterals... ......... $15.00
Lawn Sprinkler System... ....... ..$10.00
Sprinkler System (Commercial)..$30.00
Gas/Water Piping System
(Commercial)..................... ...$50.00
Permit Issuance Fee................ .$25.00
Current License on File
Comment:
Total
DYes 0 No 0 NjA
I
Rev. 2008-10
~
I
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Yr. :f~ ~ ....
2: .",...~ J.)
MEC~~S~i~ !~~~!.N~r!!LICA TI03N. 0 6 Lf
218 South 16th Street l
Blair, Nebraska 68008
Fax (402) 426-4195 M 1802
(402) 426-4191
Application Date: 1,;7-3-08
Job Address
/338
Permit Fee: $
80,C:d,J
IV cf.i:vl t"<<J 1 CL c5} I '
Zip
Owneyr]
1. \..::J v1 c;I (ljJ
Contractn .
2. L n.
3. Class of W rk:
Describe Work:
4.
Heat Pump
Central AlC -3
Furnace 75J 000
# of Units
Tons
Tons
BTU/H
A/C
Furnace
Completion Date:
Boiler Chart
BTU Fee
Up to 100,000.............................. ..$15.00
100,000-500,000......... ... ... .. .......... ...$30.00
500,000-1,000,000.................. ........ .$40.00
1,000,000-1,750,000....................... .$60.00
Over 1,750,000.................... ...... ....$100.00
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions oflaws 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.
/.,.l.. .3. 0 '5f
Date
Phone
Zip Phone
/ t:/ c?rP l.;. /tJi lit. ZlJai1
Addition 0 Alteration 0 Replacement
q() 0 C>
Furnace/Heat Pump/Air Conditioner (Per Unit) ?<;;} C .
Up to and including 100,000 BTU / 3 Ton.. ......... .............. ...$15.00
Furnace/Heat Pump/Air Conditioner (Per Unit)
Over 100,000 BTU / 3 Ton......................................... ....$25.00
Refrigeration Units/Coolers/Lines/Compressor - Commercial
(New or Replacement) (Per Unit)
. .. . .. . . . . .. .. . .. . .. . . . . . . . . .. .. . .. . . . . .. . .. . .. . . . . .. .. . . . . .. .. . .. . .. . .. . .. .. .$15.00
Boiler (use BTU Chart to left)....................
Appliance Vent/Fans... ... ... ... ... ... .. ....$10.00
/().oo
15,00
Duct System................................ ..$15.00
Gas/Air OutIets.................First 5
x $6.00
... .. .. ..Additional
x $1.00
Radiant Heat Systems/Gas/Water
Piping System... ... ... ... ...... ... ... ...... ..$50.00
Modular Home............................... $50.00
Permit Issuance Fee... ... ... ... .............. $25.00
Total
deS', C> 0
o . CJ()
Current License on File 9"Yes 0 No 0 NjA
Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: 3 . p f J.uU.~
I
Rev. 2008-10
Residential, multiple family _ Residential, one- and two-family
Residential, care/assisted living facilities
Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous _
Is building required to be protected bv automatic fire sprinkler svstem?"
No
Only partially in some areas or rooms Please Specify
Yes _ If yes, the standard to which the sprinkler system will be designed:
NFPA 13 NFPS 13R NFPA 13D
Driveway Grade: (percentage) (Dale will review new residential construction) (AI
will review all second access requests and industrial and commercial driveway requests)
Required Off Street Parking:
Permit Fee Calculation:
RESIDENTIAL - NEW CONSTRUCTION:
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
All other permits valued under $10,000 No Deposit Fee
Permit fee is: ; I
Finished sqjft area I Lf
(not including finished basement area)
Finished basement sqjft area
Unfinished basement sqjft area it! '10
Garage sqjft area Lf5 (jJ
Total Valuation:
X$88
X $53
X$26
X$20
$ / c-;)11 ,3/JJ IJ
,
$
$ ':::z,i3 ,;?;;J,;). oil
$ ql I J 0 t'~
$ ilw,7C().<<)
,
Total Valuation
Multiplied by 0.0056 =
$ q8q +)'z,
$ 20.00 ::;.
$ I
Issuance Fee:
Total Permit Fee = Deposit/Permit Fee/Issuance Fee
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Business/I nd ustria IjEd ucationalj Assem bly/Factory/Storage/Util ity
*Porches with roofs/screened patios are considered additions
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
All other permits valued under $10,000 No Deposit Fee
Construction Valuation will be computed bv SQ/ft area X $60
Accessory Buildings & Interior Remodeling Projects will be computed bv SQ/ft
area X $40
Permit fee is:
Finished sqjft area
Finished sqjft area
X$60
X $40
$
$
$0 TO $49.............................................................................................. $0 (plus Permit Issuance Fee)
$50 TO $9,999............................................................................................ $50
$10,000 TO $99,999............................................................................................$50 + $6 per additional $1,000
$100,000 TO $249,999......................................................................................... $590 + $4 per additional $1,000
$250,000 TO $499,999......................................................................................$1,190 + $3 per additional $1,000
$500,000 TO $999,999......................................................................................$1,940 + $2 per additional $1,000
$1,000,000 AND OVER ......................................................................................$2,940 + $1 per additional $1,000
Permit Fee calculated from chart above
$
Issuance Fee:
$
20.00
Total Permit Fee = DepositjPermit Fee/Issuance Fee
$
Additional Comments:
Approvedbl" I$~
Date:
9/~~&
Contingent On Approval by Fire Marshall )(
Meet IBC, IPC, IMC and NEC Code Requirements
Sleeping Rooms below Story and in Basement required to have egress
x
-
For Office Use Only
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
t 1 0
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
~
Application Date:
\'D\li{()~
Job Address
DYes 0 No 0 N/A
Service Fee = (Amp Fee + $5.00 per branch circuit)
1-100 Amp Fee..................... ..$25.00
101-200 Amp Fee. .. ...... ......... .. ...$35.00
201-300 Amp Fee... ... ... ... ...... .....$55.00
301-400 Amp Fee...... ... ......... .....$75.00
401-500 Amp Fee..................... ..$95.00
501-600 Amp Fee...... ... ...... ... ... $115.00
601-700 Amp Fee...... ... ... ... ... ...$135.00
701-800 Amp Fee...... ...... ... ... ... $155 .00
801-900 Amp Fee.................... .$175.00
901-1000 Amp........................ .$195.00
IF OVER 1000 Amp
1st 1000 Amp Fee..................$195.00
Each additional 100 Amps... ......$20.00
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.
--.,
//"e-7 ~ 9.- 0
Date
1365Lf
E 3018
Permit Fee: $ 1?;;2 - &7 ( ~,
Nth Sf-
(0(> H sch (l\
All) h. 'lvn PhEf(1<;. L( S62\'
Zip Phone
o REMODELING/ADDITIONS 0 UPGRADE SERVICE
f.:;lX\lt Cc \;y ((ULW ~\j ~
Completion Date
ELECTRICAL PERMIT FEES
Upgrade Existing Service............ .$25.00
Temporary Service................. .~
Fire Alarm System..................... .00
Signs (each)........................ ......$25.00
Miscellaneous Apparatus......... .....$15.00
( 5 d.JO
CommerciallMuIti Family and All Upgrades:
# of Circuits x $5.00
Amp Fee
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
~'"1 D sq. ft. x .063
Modular/Manufactured Homes...... .$50.00
Other: (alterations, additions and modifications)
c:r 2. (p f
Receptacles/SwitcheslLighting Fixtures (110 volt only)
# of Apparatus .......... x $1. 00
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.....
x $3.00
Permit Issuance Fee................. ..$25.00
P5 ,()O
Total/3d. (jJ J
Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: Z' pJ f~
Rev. 2008-10
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
Compliance Certificate
Project Title: GRACEIWULF RESIDENCE
Report Date: 08/19/08
Data filename: Untitled.rck
Energy Code:
Location:
Construction Type:
Glazing Area Percentage:
Heating Degree Days:
2003 IECC
Blair, Nebraska
Single Family
10%
6506
Construction Site:
Owner/Agent:
Designer/Contractor:
PAUL ANDERSEN
2028 CAUBLE CIRCLE
BLAIR, NE 68008
4025332509
Compliance: 17.9% Better Than Code
Maximum UA: 262
Your UA: 215
Basement Wall 1 : Masonry Block with Empty Cells
Wall height: 8.0'
Depth below grade: 0.0'
Insulation depth: 8.0'
Window 1: Vinyl Frame:Double Pane with Low-E
Door 1: Solid
Door 2: Solid
Door 3: Glass
Wall 1 : Wood Frame, 16" o.c.
Ceiling 1: Flat Ceiling or Scissor Truss
800
0.0
10.0
52
125 0.320 40
20 0.140 3
20 0.150 3
20 0.250 5
1224 19.0 0.0 73
1514 19.0 19.0 39
Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building has been designed to meet the 2003 IECC requirements in
RES check Version 4.2.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist
Name - Title
Signature
Date
Project Title: GRACElWULF RESIDENCE
Data filename: Untitled,rck
Report date: 08/19/08
Page 1 of 1
.--., '--"-~,""'-.- ~-~-,,"'''''''''''''---~r::?""'==-~~'='''''~'~C::'~'~~~~'''''''~:;~'''~'~~"',~~~_~,""'''7~,L~'~"_"~~;~~',7'"
BUILDING INSPECTION REPORT
"l
~-CITY OF BLAIR
LOCATION OF INSPECTION'
,/'j. 1:;
( f _ '7 1 /) PI;
NAME OF OWNER' c....'i ( /J (j CJ U (}~t"p,.J
-, (/
DATE INSPECTION REQUESTED,q - / ~? - () 8
D WASHINGTON COUNTY
I? """0
, -~ ~':5 ;:)
D OTHER
X if ti " 'd! /
.I \[ J {pI a~,.f.-. L<.....
'./-:) -;: ., ;;'
'~ .~...-",;; / ~ ""II/I ,""',"
CONTRACTOR' / (,,{:.t./f ~4/17aM<.)O-' 7
/,,! , I'" <"--7/ "/,,./ 1;.- )
i /,1' /-.," /, > !! '~/II/1 Tv,'11 L'
TIME INSPECTION REQUESTED vi?' I CJ (../{ 1(/ &"'7> (pI' L.PERMIT NO'
/ c"'7 /' 5<--" / l
j ~J () " ~~/~
TYPE OF INSPECTION REQUESTED: D CONFERENCE
~ ~~~~"',_~ ,Il-'- _'"""""= "-_
BUILDING: ~OTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
COMMENTS:
UTILITIES: 0 SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
D STATUS CHECK
fi F~ED
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH..IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D' D
COMMENTS:
FAILED
D
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
,',
"
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,~
,,,,.
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BUILDING INSPECTION REPORT
Ef~ CITY OF BLAIR D WASHINGTON COUNTY
LOCATION OF INSPECTION' I :33 ()
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BUILDING INSPECTION REPORT
t.:l~rrY OF BLAIR 0 WASHINGTON COUNTY
LOCATION OF INSPECTION' / 33 f}
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PLUMBING PERMIT A~lfLICATION
Jurisdic~~~ ~~~::;l~fhBd~~~tNebraska / 3tJ 5' Lf
Blair, Nebraska 68008
Fax (402) 426-4195 P 1940
(402) 426-4191
Application Date:
/()-7--08
5"500
Permit Fee: $ '-- C .
Owner
1.
Contractor
2.
3. Class of Work:
Describe Work:
4.
Job Address
Comments:
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions oflaws 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.
Date
NJiucwiC0
Zip
7 ~ ., LfS9(; 0
Phone
Zip
o Repair 0 Replacement
aJ (1~
PLUMBING PERMIT FEES
Modular Home... ... ... ...... ... ....$50.00
Type of Fixture No.
Kitchen... ... ... ... ... ... ... ... ... ...$12.00 x
Bath... ..Residential/Single Stall $12.00 x _
................ ....Multi-Stall $25.00 x
Rough-In Bath.... ... ... ... ... ........ $8.00 x_
Additional Sinks.... ............... ..$6.00 x
Slop Sink/Laundry Tray/Drain.....$6.00 x_
Water Heater..................... ....$10.00 x
Outside Water Faucet...................$6.00 x
Drinking Fountain........................$6.00 x_
Backflow/Grease Trap........... ..$15.00
Water Service............... ... ... ..$15.00
Sewer............................. ....$15.00
Groundwork..................... ....$15.00
Septic Tank & Laterals... ......... $15.00
Lawn Sprinkler System......... ...$10.00
Sprinkler System (Commercial)..$30.00
Gas/Water Piping System
(Commercial)............... ... ... ...$50.00
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Permit Issuance Fee................ .$25.00
"',06
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Current License on File
Comment:
Total
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DYes 0 No
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: $. pJ/~
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Rev. 2008-10
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BUI~DING'INSl?ECTION REPORT
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~CITY OF BLAIR 0 W AS,HINGTON COUNTY 0 OTHER
LOCATION OF INSPECTION' I ~'?3 f) ,1,l'7.61 U4~ C~
NAME OF OWNER' /;;,/1 (] tV !Jc.'{l--- CONTRACTOR' (/.1;; C;?$;J471 ~
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PASSED FAILED
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NOTESIREMARKS'
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BUILDING INSPECTION REPORT
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LOCATION OF INSPECTION'
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COMMENTS:
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COMMENTS:
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PERMIT NO' 13 0 ,~V
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LOCATION OF INSPECTION'
NAME OF OWNER' (J~ 0 I ~
TIME INSPECTION REQUESTED'
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE D STATUS CHECK
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BUILDING: D FCiOTING D DECK FOOTING\0' FRAMING D DRYWALL 0 FINAL D PARTIAL
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COMMENTS:
UTILITIES:, D SEWER TAP; D SEWER D SEPTIC D WATER TAP D REMOTE 0 WATER SERVICE
o PARTIAL .
PASSED FAILED
D 0
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ROUGH IN D FINAL' 0 PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
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COMMENTS:,
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MECHANICAL: Q/ ROUGH-IN D NC 0
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FURNACE D RADIANT HEAT 0 FINAL 0 PARTIAL
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PLUMBING: 0 GROUNDWORK{J/ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
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PASSED rAIL
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BUILDING INSPECTION REPORT
~TY OF BLAIR 0 WASHINGTON COUNTY 0 OTHER
LOC:ION OF INSPE~I9N' /3-58 Ai J 124 Ct<J !L,q:- Sf,
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NAME OF OWNER' I v'1tJ ~.Jl i (~{.. CONTRACTOR' CJl7 afr'::Yl'l/7 a.l'7
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DATEINSPECTIONREQUESTED.I - ;; / ~ d/9 TIME INSPECTION REQUESTED' /c:J.' tJ 0 fi ';VI. PERMIT NO'
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TyPE OFINSPECT~?~ REQUEST~_ _ Q~~!!RENCE~-._ 0 STATUS CHECK
BUILDING:' 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL PASSED FAILED
o 0
COMMENTS:
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o SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
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ELEcTRICAL: 0 ROUGH IN 0
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FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
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MECHANICAL:
AlC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o 0
COMMENTS;,
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:,PL~INJ}:':'li::~:O:S; ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
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D ().Gc.~A:N(ni",g~wrED" ITJ' cO@tTION~LOC.CiJp ANCY GRANTED
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BUILDING INSPECTION REPORT
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EJ... CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
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LOCATION OF INSPECTION' I..:~. .),r::) /\J ,.,1 i. "~I ,t,;'! (""..i i
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NAME OF OWNER' C'...,:c4:;1'(}/ /;;'_.l;Q.l,~i1;'.j CONTRACTOR' / >?I/; ,':1 ':,~~:" () ~<_;. '.,
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TYPEOFINSPECTIONREQUESTED:U f4/3~ <> ~71' D CONFERENCE DSTATUSCHECK
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL,:'E~(FINAL D PARTIAL
PASSED FfIL~
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COMMENTS:
II ~TILITIES:
JTC41 t ~
COMMENTS:
D SEWER TAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
;?J'l~T"~tB :~~~~A~:'gJ'FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
COMMENTS:
MECHANICAL:D ROUGH-IN D NC D FURNACE D RADIANTHEAT EJ;;:EiNAL D PARTIAL
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mMMENTS:
P~ED ~
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PLUMBING:
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lOMMENTS:
D GROUNDWORK D ROUGH-IN:"g""'FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
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DATE OF INSPECTION MADE: 7-- (QI.. ? ~~ TIMF'c3~
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
D WASHINGTON COUNTY
D OTHER
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CONTRACTOR'il::~~,t{// , /<,). ,//)'/t:'/';;:>l",J (r;t'")
LOCATION OF INSPECTION'
TIME INSPECTION REQUESTED' // ' ':5 ';:?,lJ-/i,4' PERMIT NO'
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NAME OF OWNER' (:,,//,:~,/ (:;:'
DATE INSPECTION
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL,!:J:::FINAL ~ARTIAL
D STATUS CHECK
XD F~ED
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
COMMENTS:
ELECTRICAL: D ROUGH ,'t,iFINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL'
PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
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INSPECTOR'
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DATE OF INSPECTION MADE:
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FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
CITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
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LOCATION OF INSPECTION'
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NAME OF OWNER- (:} '(' i<' !~:'l' /<(.ii{)f~/
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DATE INSPECTION ~QUESTED' // ,;l~:;'~. O~1
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TIME INSPECTION REQUESTED' / i.,/ " U(~l.lf ' /,'1. PERMIT NO' /
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
PASSED FAILED
o 0
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATER SERVICE
D PARTIAL
PASSED FAILED
o 0
COMMENTS:
" .C'~p
ELECTRICAL: 0 ROUGH INc;E];)INAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
~F~ED
COMMENTS:
MECHANICAL: 0 ROUGH-IN 0 ArC 0
PASSED FAILED
o 0
COMMENTS:
PLUMBING: 0 GROUNDWORK D" ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR- ~0Z-;AM9-&v\. DATE OF INSPECTION MADE, I J-.;;z5-~mw- /C):CJS:
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY