BP13073Blair Building Permit Detail
Permit M 13073 Issued: 9/8/2008
Completed: 6/14/2010
Location: 14373 St Hwy 91
Owner: Bennett Ihrke
Address: 14373 St Hwy 91
Blair, NE 68008
Phone: 4265724
Section: Township: Range:
Subdivision: Lot:
28 x 60 Garage with electric and concrete floor
Contractors
SELF
Dick's Electric
Remarks
Type: Accessory Building
Valuation: 67200
General Contractor
Electrical Subcontractor
1/6/2009 DEM OPPD Faxed
2/4/2009 DEM
2/26/2009 DEM
No siding installed.
Siding Not Complete.
Electrical Not Complete.
Permit Fee:
343.2
Issue Fee:
20
Deposit Amt.:
500
Receipt M
23111
Block:
Permit # Issued
E3053 12/31/2008
3/2/2010
HOW
1. Provide truss clips for N. wall roof trusses.
2. Finish office framing.
Inspections Date
By
11/412008
DEM
Footings
Pass
12/912008
DEM
Framing
Pass
11612009
DEM
Electrical Permanent Service
Pass
2/312009
DEM
Final Inspection of Project
Fail
2/26/2009
DEM
Status check
Pass
3/1/2010
KAR
Electrical Final
Pass
311/2010
HOW
Final Inspection of Project
Fail
6/14/2010
HOW
Final Inspection of Project
Pass
l~ f : 5
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit# 13~73
Date:-3-8'~08
Approximate Completion Date: JJ ' 3 D-o B
Site Plan Attached: Y REScheck Attached:
Complete Plans Attached
Application for: Residential ><' Commercial/Industrial
New Construction Manufactured Home Modular
Move-on: Home Accessory Building ~ Other
Remodel Addition
Accessory Building: Garage x.. Pole Barn_ Other
Floor Type: Dirt Concrete ~ Electricity: Yes..k.. 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 _
;;;g Y. /.ti 0 f f!CM a tfP tud;/u
Proiect Information:
Legal Description (if applicable)
ownerzJ] Ml/tlJ!:l .IA~
I If 2> fJ"3 S!-ab HW'j 9/
(1./ tit!{ q - / f3 .- / / It;; B
Address: C~011t1 Od obtJvh
8700 I 0//5 q
PL!;// /{). t/IfAb
Phone#: if 2&- 57;? if
Phone #: gee> - 3& t.f8 fXi:y::r
Job 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
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
1.8.DA 0 ays or is not completed wit _ . 0 (2) years of date of issue. #
l6.fLt, " ~_ ~1 <~[)I ZOO[(
Signature of Owner/Contractor Date
,<
...
ZONING REVIEW:
ZonimVFlood Plain/Utilities:
Current Zoning: ~
Conditional Use Permit Required: Yes _ NO~
Date CUP Approved:
State Fire Marshal Required: ,Yes _ No X Variance Required: Yes _ No_
Minimum Setbacks: Fron~ Second Front . Side Side;;tj Rear~
Lot Sauare Footal'!e:
Length x Width: Lot Coverage % (j)L
Driveways/Sidewalks: \ ~"'.
Sidewalk required: Yes_ No -tJ... \ \ idewalk Waiver: Yes _ No
I: ate Waiver Approved:
Flood Plain: Yes No
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
Number of Stories
One Two
Three
Four
>Four
High Rise (> 75 ft) _
Type of Residential Structure:
Ranch _ Two Story _ Split Entry _ Raised Ranch _ Other
Rooms _ Bedrooms _ Bathrooms __ Fireplaces _ Gas_ Electric _
Egress in Basement: Required: Yes _ No _ Provided on Plans: Yes No
Sleeping Rooms Living Area Other Egress
Sauare Footal'!e:
Main Level:
Basement: (Unfinished)
Garage:
Detached Garage:
Addition:
Porch: Front
Deck that affect setbacks:
Second Level: Third Level
(Finished)
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front Side
Rear
Rear
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, Iibrqries, 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 _
Institutional, day care facilities _ Mercantile Residential, hotels _
Residential, multiple family _ Residential, one- and two-family
Residential, care/assisted living facilities
Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous ----.--
Is buildinJ! reQuired to be protected by automatic fire sprinkler system?"
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:
BuildinJ! 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:
Finished sqjft area
(not including finished basement area)
Finished basement sqjft area
Unfinished basement sqjft area
Garage sqjft area
Total Valuation:
X $88
X $53
X$26
X$20
$
$
$
$
$
$
$
$
Total Valuation
Multiplied by 0.0056 =
Issuance Fee:
20.00
Total Permit Fee = DepositjPermit Fee/Issuance Fee
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Business/I nd ustrialjEd ucationalj Assembly/Factory/Storage/Util ity
*Porches with roofs/screened patios are considered additions
BuildinJ:! 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 $ ~o6, '1;7
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 Buildin2s & Interior Remodelin2 Proiects will be computed by Sq/ft
area X $40
Permit fee is:
Finished sqjft area
Finished sqjft area
/6~6
.
X$60
X $40
$
$ 1.0>1, ;?.oo . 00
.
$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
$ 3tf3. ;}-o
Issuance Fee:
$
$
20.00= 3/J '8 ;}- 0
B &> '8. J-O
Total Permit Fee = DepositjPermit Fee/Issuance Fee
Additional Comments:
~/~
Approved IJy; -; )d7 ~L-JDate:
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
For Office Use Only
Date Permit Paid: 9" I 5' - () /Cj
Permit Fee: .8 (y ii. ?- ()
Deposit Amount 5tH) ..0(1
Receipt # .:23 {/ / (~ :/....L.
Deposit Paid by for return to: C j)..J!/Yl/Y/JU I h~
l'l3 7.B cr/afJl)/w!I q I
(3Jat~ vgOb8
Building Inspection Pouch given: Yes ~ No_
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CllY, STATE, ZIP CODE
THANK YOU
KEEPTHIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
~
E~ECTI~JJ;AL PERMIT APPLICATION
- - rt:'n' (\ Jurisdiction of City of Blair, Nebraska '2.. 18
~ 218 South 16th Street \ 'J D
Blair, Nebraska 68008 ~
Fax (402) 426-4195 E 3053
(402) 426-4191
Application Date: \ d/l2> I I D 1S
Job Address
Permit Fee: $ (;3, 00
gl
3'13~u
Zip
I I Phone '
'-126" S'l;)Jl-1
Phone
o,\f'Jlr Mail AlIdress
1. r~ n Ih y t.l Si~'\11U-
cptl,tractor., , \ t" I ~'.. .h ~ail Address
~U )Cll S '/UC_1 Y Ie.
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL
Descr.>>1\ Work:, ,j) It", ,tIfj C ' L .,1\.. ,...
4. / \ ro ,~)2D A\'V1I'~ \ r U Il 2>C~ KJ,:vt>~~
5.Current License on File ,.0 Yes 0 No 0 NjA
-:,
Service Fee = (Amp Fee + $5.00 per branch circuit)
l-IQO Amp Fee...... ... ...... ...... ..$25.00
10[~OO~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
15t 1000 Amp Fee...... ........ ....$195.00
Each additiona1100 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 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.
orized Agent
Date
Zip
o R,EMQDELINGjADDITIONS 0 UPGRADE SERVICE
\ "
~,)6[) Se VCQ sJ1h .7
Completion Date
ELECTRICAL PERMIT FEES
Upgrade Existing Service............ .$25.00
Temporary Service.. .. .. .. .. .. .. .. .... $15.00
Fire Alarm System................. ....$15.00
Signs (each).. . .. .... .. .. .. .. .. ... .. ......$25.00
Miscellaneous Apparatus......... .....$15.00
CommerciallMulti Family and AI~_~Dgrades:
# of Circuits x $5.00 'U
~-r" '"""",
, :,.;-'::) ,C.Y'
Amp Fee
Amp Fee + Circuit Total
~5S'lDD
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x .063
Modu1ar/Manufactured Homes...... .$50.00
Other: (alterations, additions and modifications)
Receptacles/Switches/Lighting Fixtures (110 volt only)
# f A "--;J $ .--, ',0
o pparatus .......... ~ x 1.00 ,'::::>. C
-
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.....
x $3.00
Permit Issuance Fee................. ..$25.00
~IOU
3,00
Total
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: $, ?Jf~
I
Rev. 2008-10
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CITY OF BLNQ
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected at the time of your building
permit -rapplication for all commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater. 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)No stop box location card submitted, (with new service only)
3) all required inspections have not been obtained,
4) occupancy occurs prior to a final inspection,
~ 5) all permits have not been obtained,
~ 6) 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
forfeited or discounted upon the discretion of the City of Blair, Building and
Inspections Department.
~
Contractor/Owner
2~ IS/Zoo?
City of Blair
Gl-
EQUAlIIO!JS!U(1
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cltyofblair@ci.blair,ne,us ",,,,"""
CITY OF BLAIQ
..., .\.,1-
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BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet includes various items dealing with particular code
requirements and/or building permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2006 International BuildinQ
Code requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in your building permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
I have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner/contractor for this project.
~
~
Contractor
City of Blair
~Jyj- {~20- ~
~
(5)-
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402.426-4195 . E-mail cityofblair@ci.blair.ne,us ,~~';-~7JJ~:
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BUILDING INSPECTION REPORT
'[:f:CITY OF BLAIR
LOCATION OF INSPECTION'
? . / f
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NAME OF OWNER,. /jjI;t f -L_ //t ~-
DATE INSPECTION REQUESTED' /1" if - C)c.tJ
D WASHINGTON COUNTY D OTHER
/ if 3 17 3 (j\~',;.:1 /c.f 17{'-) (../ '7/
r'~--:_) , ~...:, ...r,........
CONTRACTOR' /~o'7? ~) / () - O()(:-:f II
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TIME INSPECTION REQUESTED''':) ',.":).():r::,. "1'1 ' PERMIT NO'
,
,
/3073
TYPE OF INSPECTION REQUESTED: D CONFERENCE D STATUS CHECK
=::;';'~~'=~~"!m..~.s.=a::s'~~~~..:ct&,"""",~...._...---~..,.~.:==:l:za'i!'llZr<1~t:mZ1!::::.:..O.,Z:t'Z:=2!~~ __~
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BUILDING: ..':i~ FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
COMMENTS:
PASSED FAILED
~D
t:.':.~~~;l:~~~~~a;;.;~~1:~~~~~~~L~~~
UTILITIES: D SEWER TAP
D PARTIAL
COMMENTS:
ELECTRICAL: D ROUGH IN
D PARTIAL
COMMENTS:
MECHANICAL: D ROUGH-IN
D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
PASSED FAILED
D D
FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
PASSED FAILED'
DD
D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
FAJLED
D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
o OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GR~TED
NOTES/REMARKS'
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BUILDING INSPECTION REPORT
/
jZJ CITY OF BLAIR
D WASHINGTON COUNTY
/'// "~7...-'5 7' ///,
LOCATION OF INSPECTION' , -r /..:1:::.; -,/1aj~,/
<.
D OTHER
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C;,f!' /
DATE INSPECTION REQUESTED'
TIME INSPECTION REQUESTED'
PERMIT NO'
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NAME OF OWNER' ~_~-' / I /'-.-/t. C.
CONTRACTOR'
..!YPEOFINSPECTIO~REQUE~~~ ~__ _~_ ~QE_~NFE~~~_.Q~TATU~~E~_
BUILDING:. 0 FOOTING D DECKFOOTLNG D FRAMING D DRYWALL D FINAL D PARTIAL PASSED FAILED
D D
CONlMENTS:
~~~~~~
-,. '. " '., /
UTILITIES: 0 SEWER TAP D SEWER IZl SEPTIC D WATER TAP D REMOTE D WATER SERVICE
/
D PARTIAL
P9 F'tJED
ELECTRICAL: D' ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
CONlMENTS:
"1~=l!lilt.31\a~ll,;'WZClQSZ!llil~I"'~~~~""""~_~
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MECHANICAL:q ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
CONlMENTS:
PASSED FAILED
D D
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PLuMBING:::: DOROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED
. ... . ,:1:", E]PRESSURE TEST
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[] " ,OCCtJpkN<titG'~:W~btD . 0 CONDITIONAL OCCUPANCY GRANTED
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NOTES!REMARKS" ...,..
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^I CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION•
NAME OF OWNER` _ _ _ CONTRACTOF • _
DATE INSPECTION REQUESTED' TIME INSPECTION REQUESTED' PERMIT NO•
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE
~ ^ STATUS CIiECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL
^ PARTIAL .PASSED FAILED
^ ^
COMMENTS:
1
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_ ~_ ~ _~__u-
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE
PASSED
FAILED
^ PARTIAL ^ ^
COMMENTS:
ELECTRICAL: ^ ROUGH IN ^ FINAI, ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PAS D FAILED
^ PARTIAL ^
COMMENTS:
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL _ ,~~~_ 'PASSED FAILED
^ ^
COMMENTS:
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL ~~ PASSED FAILED
^ PRESSURE TEST ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED:
NOTES/REMARKS
INSPE.c Tc~I~~. -:-`~.
Fi~aED OPPI~\I3WZT REA
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BUILDING INSPECTION REPORT
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~DTY o'F BLAIR
LOCATIo'N o'F INSPECTIo'N'
NAME o'F o'WNER' ~f).}1/IU!jj :;:::1(/li!/~
--
DATEINSPECTIo'NREQUESTEDO{'" ,.=5 -~OCI
o W ASHINGTo'N COUNTY 0 o'THER
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TIME INSPECTIo'N REQUESTED' /1 7-- PERMIT No"
Co'NTRACTo'R'
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE o STATUS CHECK
~~-~ ~~~~~ ." '~
BUILDING: 0 Fo'o'TING 0 DECKFo'o'TING ',0 FRAMING 0 DRYWALL c:F'FINAL 0 PARTIAL PASSED fA D
-" '? '.; ,I ' 0 ~
:=~w:~~~w~s~ AlLED
o PARTIAL' 0 0
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PASSED !'ArLED<Z
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COMMENTS:, =_ __. _ . .~=r-===_..,,,,,,,-===-~\,'~tf:?',~
PLUMBING: 0 GRo'UNDWORK O. Ro'UGH~IN, 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL PASSEDFAIL~P~~;~"~~~
COMMENT", D'PIlESSURETEST. ...... _ __ _.--=---D.,.,'..;...,.:";,',...".i,~,,r,:,~.~j~,'c.
. D bCCUPANCi'GRANi.ED.dJ';;CONJJIiiO~AA;()CCtJpANC.YGRANTED ' ~
N<YrES!REMAliKS <~tr{ ...... ...... . ..tG ~!,X;;ti0fi
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PASSED
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COMMENTS:
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ELECTRICAL: 0 Ro'UGH rN"'EZI~FINAL 0 PERMANENT SERVICE 0 TEMPo'RARY SERVICE 0 PRECo'NNECT
o PARTIALI
COMMENTS:
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MECHANICAL:D Ro'UGH-IN D AlC 0 FURNACE 0 RADIANTHEAT D FINAL 0 PARTIAL
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BUILDING INSPECTIONREPufi.l
/
/
IZJ CITY OF BLAIR
o W ASHlNGTON COUNTY
o OTHER
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LOCATION OF INSPECTION'/ 4,L~-::~'? 7~ ~:?
<--~'--.. / / -::= //"/""
NAME OF OWNER' " L/7/Cj(, L_ CONTRACTOR'
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DATE INSPECTION REQUESTED' C:::-."', /~:;;)(p /t) 7 TIME INSPECTION REQUESTED'
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(<~'/
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i}/1' 11/1
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PERMIT NO' //::j~7 ::;7 ::?
/
TYPE OF INSPECTIQN REQUESTED: 0 CONFERENCE GJSTATUS GHECK
~~~ 'T"'~~\.=_"~~~~"""'-:- .re. -~
BmLDING: O' FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL PASSED FAILED
o D
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
o S~WER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATERSERVICE
tJ PARTIAL
PASSED FAILED
o 0
UTILITIES:
PASSED FAILED
o 0
MECHANICAL:Q ROUGH-IN 0 NC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
COMMENTS:
PASSED FAILED
[j 0
PLUMIHNG:. 0 Gl{OUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
.' D PRESSURE TEST
COMMENT~: ,
PASSED FAILED
[1,0
D . QCCUPAN~cfGR,tNTED d, l1J' CONDITIQNAL OCCUPANCY GRANTED ,
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SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PARTIAL
PASSED
❑
FAILED
❑
CITY OF BLAIR ❑ WASHINGTON COUNTY El OTHE
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PARTIAL
PASSED
❑
FAILED
❑
MECHANICAL: ❑
COMMENTS:
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
❑
FAILED
❑
LOCATION OF I N S P E C T I O N -
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PRESSURE TEST
PASSED
❑
FAILED
❑
b - ;
NAME OF OWNER «�� `�� ` '� t_ w CONTRACTO
DATE INSPECTION REQUESTED
EQUESTED - ` V ' ti TIME INSPECTION REQUESTED
x P PERMIT NO
y
-
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FR.AMING ❑ DRYWALL j_ -FINAL ❑ PARTIAL
PASSED
FAILED
El
1
COMMENTS:
UTILITIES: ❑
❑
COMMENTS:
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PARTIAL
PASSED
❑
FAILED
❑
ELECTRICAL: ❑
❑
COMMENTS:
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PARTIAL
PASSED
❑
FAILED
❑
MECHANICAL: ❑
COMMENTS:
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
❑
FAILED
❑
PLUMBING: ❑
❑
COMMENTS:
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PRESSURE TEST
PASSED
❑
FAILED
❑
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES /REMARKS ` ) -t cc Felp- I-✓ ae G L 2 cJ +v to .Qs
"1
1
1
1
INSPECTO G ��I,,�J � DATE OF INSPECTION MADE: � I 0
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
T IME:
i
B UILDING
w❑ _ CITY OF BLAIR ❑ WASHINGTON COUNTY F] OTHER- . .,
LOCATION OF INSPECTION � -
r
NAME OF OWNER -- . %LL ✓ ✓' < CONTRACTOR=
DATE INSPECTION REQUESTED x f TIME INSPECTION REQUESTED
p
ID : hi PERMIT N0
a
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED
❑ ❑
COMMENTS:
UTILITIES: ❑
SEWER TAP
❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ROUGH IN _ _...
FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSE
FAILED
❑
PARTIAL
❑
COMMENTS:Qr
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMM ENTS:
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN [_1 FINAL El WATER METER INSTALLED El PARTIAL PASSED FAILED
❑ PRESSURE TEST ❑ ❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
INSPECTOR. . DATE OF INSPECTION MADE: < TIME:_
FAXED OPPD\BURT REA TO CONNECT SERVICE: 0 N BY
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,CITY OF BLAIR
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1 9 0411 1 go Rl U DEN ll I, I iiiii'l � III
F WASHINGTON COUNTY
LOCATION OF INSPECTION
NAME OF OWNER
F OTHE
DATE INSPECTION REQUESTED:-��� TIME INSPECTION REQUESTED 2 / 2- i '2 'I.PERMITNO -
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE Fl STATUS CHECK
BUILDING: ❑
COMMENTS:
FOOTING ❑ DECK FOOTING [:1 FRAMING [:] DRYWALL PARTIAL
PASSED
F
LED -
F
UTILITIES: ❑
❑
COMMENTS:
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP F REMOTE ❑ WATER SERVICE
PARTIAL
PASSED
F
FAILED
1
ELECTRICAL: ❑
❑
COMMENTS:
ROUGH iNF] FINAL F PERMANENT SERVICE F TEMPORARY SERVICE F] PRECONNECT
PARTIAL
PASSED
❑
FAILED
F
MECHANICAL:F
COMMENTS:
ROUGH -IN F A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
1
FAILED
F
PLUMBING: F
❑
COMMENTS:
GROUNDWORK ❑ ROUGH-IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PRESSURE TEST
PASSED
❑
FAILED
❑
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS -
INSPECTOR DATE OF INSPECTION MADE: F. 10 AWL-
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON