BPM1797
Permit #: M1797 Issued:
Completed:
Location: 812 N 12th Street
Owner: Mike Claywell
Address: 812 N 12th Street
Blair, NE 68008
Phone: 2780219
Section:
Subdivision:
Replace Heat pump - outside unit.
Township:
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Blair Building Permit Detail
11/20/2008
11/24/2008
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Type: Mechanical Miscellaneous
Valuation:
Range:
Lot:
Contractors
Washington County Heating & NC Inc. General Contractor
Remarks
Inspections Date
11/24/2008
11/24/2008
By
OEM
OEM
Mechanical Final
Finallnspeclion of Project
Permit Fee: 15
Issue Fee: 25
Deposit Amt.:
Receipt #:
Block:
Permit #
Issued
Pass
Pass
"rWBLAIR
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
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NAME OF
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DATE INSPECTION REQUESTED' f f
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TIME INSPECTION REQUESTED"
TYPE OF INSPECTION
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL
o CONFERENCE
FINAL 0 PARTIAL
o STATUS CHECK
f?D F~ED
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE OW A TER SERVICE
PARTIAL
PASSED FAILED
o 0
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
MECHANICAL: 0 ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT
PASSED
0 0
FAILED
0
PASSED FAILED
0
FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0
o
ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
COMMENTS:
o OCCUPANCY GRANTED
CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS"
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
INSPECT
DATEQF INSPECTION MADE:
MECHANICAL PERMIT APPLICA
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008 ~ 0
Fax (402) 426-4195
(402) 426-4191 '
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3. Class of Work:
Describe fY-ork:
4. I~e.
Heat Pump
Central AlC
Tons
Tons
Furnace
BTU/H
AlC
# of Units
Furnace
Completion Date: \ \- 2. '-t --0 ~
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.
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Sig Q~~c ntrac r 0 uthorized Agent
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/ / Date
M 1797
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Zip
Zip
,0 Repair
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MECHANICAL PERMIT FEES
/5.00
Furnace/Heat Pump/Air Conditioner (Per Unit)
Up to and including 100,000 BTU / 3Ton............................$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
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
25,00J
40, 00
Current License on File -M es 0 No 0 Nj A
Comment: , _ _ "al t.I '" () B
':C:fY~~ ~L" 1, I : ()O p ~,fl'\'
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: h Lou 61 f\1J /L
-
Rev. 2008-10
';A'\
--:g/:bL~Y OF BLAfR D WASHINGTON COUNTY
LOCATION OF INSPECTION' '6' 12 N
NAME OF OWNER' fVI1 Vti'..... ~ \ dt[ \N ~J I
DATE INSPECTION REQUESTED' II ~:<. Ll - Db
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BUILDING INSPECrlON'REPORT
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TYPE OF INSPECTION REQUESTED: D CONFERENCE D STATUS CHECK
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BUILDING: D FOOTING D DECKFOOTJNG D FRAMING D DRYWALL;U FINAL D PARTIAL P~D F~ED
COMMENTS: JL1
~----- -
""-"'.....",..,..,...".,.,.-=~
tztt;'~~~~
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D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D 'WATER SERVICE
o PARTIAL'
UTILITIES:
", CQMMf:.t'l'TS:
PASSED FAILEO
D Dl
i' . it'
.~~ .......,.......-.~~~
, '/1
ELECTRICAL: D ROUGHIN D FINAL 0 PERMANENT SERVICE D TEMPORARY SERVICE DPRECONNECT PASSED FAILrD
D PARTIAL 0 D\,',
COMMENTS:
-~~c~':DG~~~"~CE D~~~,. .. P P1?ASS FOb
COMME_~TS: _. '" ~.ct:r JJ2lli1U2m"""_~~_==__._,,~__ 'F'
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL PASSED FAILED
D PRESSURE TEST ' D D
COMMENTS:
---1!l--
'W~I':""mil:l:'o/"" iT ~~"'"~
D OCCUPANCY GRANTED
'<;ONDITIONAL OCCUPANCY GRANTED,
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NOTES/REMARKS'
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11/24/2008 01:08 PM
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