BP13139
Blair Building Permit Detail
Permit #: 13139 Issued:
Completed:
Location: 13121 Co Rd 16
Owner: Country Bible Church
Address: 13121 County Rd 16
01/21/2009
05/05/2009
Type: Church - Remodeling
Valuation: 8385
Blair, NE 68008
Phone: 402 426 5592
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
153
25
200
24022
Section: 34
Subdivision:
Township: 19
Range: 11
Lot: 99
Block:
Putting up modular walls. Will have electric. Will have HVAC.
Contractors
D.A. Boswell Company
Hipnar Electric
Remarks
General Contractor
Electrical Subcontractor
Permit #
E3076
Issued
02/26/2009
02/20/2009 OEM
Walls request by Robert Swinney who gave don the web site to buy the walls. The Church
board request these wall with this design you have at least eight junction boxes in the attic.
By having an electrician wire you would only have one or two boxes.
02/20/2009 OEM Boxes are not considered accessible. 314.29100 definition.
Inspections Date By
02/20/2009 OEM Framing Fail
02/23/2009 OEM Status check Pass
03/02/2009 OEM Electrical Rough-ins Pass
05/05/2009 PHIL Electrical Final Pass
05/05/2009 PHIL Final Inspection of Project Pass
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # (3 k~) <j
Date:
! "' ;;;./- 0 q
Approximate Completion Date:
f""_
Site Plan Attached:
REScheck Attached:
Complete Plans Attached ~
Aoolication for: Residential Commercial/Industrial _
New Construction Manufactured Home Modular
Move-on: Home _ Accessory Building Other
Remodel ~ Addition
Accessory Building: Garage _ Pole Barn_ Other
Floor Type: Dirt _ Concrete _ Electricity: Yes _ No
Sign Erecting, Awnings _ Decks/Handicap Ramps (plot plan required) _
Satellite Dishes/Radio Antenna/Cell Towers (plot plan required) _
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 _
/1>n 0 ctu_lel" v
/7 C! /
Proiect Information:
Job Address:
(,Sf:;?)
Clr7,
C () LI/17 lLl~ ~C/
(/
'71-- </"1 .:~l4-1 '7 - II
/!I' C L/ c)t):J c) '7 c;
Legal Description (if applicable)
Ii.. . .... 2'7 I (1 /;tl/J a/1
Owner: L_t'Ul7/;/ti;Jl \7Llni0/ C /Address:
'\ ~/I iZ 1\ J/J1II
Contractor: / /') ,/l (L,jC-' d 'U>..lC--.U
j. /, .'. ;,.,./1(,/' J' '/ )/ j, '''1.. '/'1
_ ,'/~ (.. '-II-f."!<<' "'1(..1
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Phone #:
Address:
/..::'" .:7.
Cell #: ~_J~)
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
r 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
'.' ":rgOdaYS,ot!~~.~t C\Plet~Yii!~WO (2) years of date 0 issue.
"''', J - ~( - ~1
Date
ZONING REVIEW:
ZoninVFlood Plain/Utilities:
Current Zoning: ~. Conditional Use Permit R~quired: Yes(~ No ~
f'\\.'iU / Date CUP Approved: !-tCY.s., ~,U. 1-' '
State Fire Marshal Required: Yes _ No _ Variance Required: Yes _ NO.4-
Minimum Setbacks: Front _ Second Front Side Side _ Rear_
TJ)k
Lot Sauare Foota~e:
Length x Width:
Lot Coverage %
Drivewavs/Sidewalks:
Sidewalk required: Yes_ No_
Sidewalk Waiver: Yes
Date Waiver Approved:
Preexisting Garage requires driveway to be less than 3' from property line: Yes_
Approved by:
No
Flood Plain: Yes No
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
Number of Stories
One Two
Three
Four
>Four
High Rise (>75ft)_
Tvpe 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 Foota~e:
Main Level:
Basement: (Unfinished)
Garage:
Detached Garage:
Addition:
Porch: Front Rear
Deck that affect setbacks: Rear
Second Level: Third Level
(Finished)
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front 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, libraries, museums_
Business Educational Factory and industrial, moderate hazard _
Factory and industrial, low hazard _ High Hazard, explosives _
(section continued on next page)
High Hazard HPM
Institutional, incapacitated _
Institutional, day care facilities _
Residential, multiple family _
Residential, care/assisted living facilities
Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous _
Institutional, supervised environment_
Institutional, restrained _
Mercantile Residential, hotels _
Residential, one- and two-family
Is building reauired 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 130
Driveway Grade: 20% grade or less? Yes _ No_
(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:
Building Permit Deposit Fee:
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee";' $200.00
All other permits Fee = $50.00 $
RESIDENTIAL - NEW CONSTRUCTION:
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 $92
X $56
X$29
X $25
$
$
$
$
$
$
$
$
Total Valuation
Multiplied by 0.006 =
Issuance Fee:
25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Busi ness/I ndustrialjEd ucationa Ij Assem bly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sqjft area X $63
Except for the following:
Accessorv Buildim!s & Interior Remodeling Proiects: sqjft area X $43
Pole barns with no hard surface floor: sqjft area X $25
Sign Erecting/Awnings and Decks/Handicap Ramps: sqjft area X $25 (Minimum
valuation of $2000)
Construction valuation computation: 'q c:::-
Finished sqjft area I-J
X $ Ll.8
,:~ ^";> t,:J, ." (} ()
$ L";:J Vel
Construction valuation is ...................................Permit fee is:
$0 TO $50.......................................................... $0
$51 TO $500........................................................$25
$501 TO $2,000........................................................$25 + $3 per additional $100
$2,001 TO $25,000........................................................$70 + $13 per additional $1,000 t':
$25,001 TO $50,000..................................................... $370 + $10 per additional $1,000
$50,001 TO $100,000..................................................... $620 + $7 per additional $1,000
$100,001 TO $500,000..................................................... $970 + $5 per additional $1,000
$500,001 TO$1,OOO,OOO ..................................................$2,970 + $4 per additional $1,000
$1,000,001 AND OVER ..................................................$4,970 + $3 per additional $1,000
(.'
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Permit Fee calculated from chart above
/,53,
(;/
Issuance Fee:
$
$
25.00 '::;. i '7 B . ()(,
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
$ r!?7tj, ell.)
,.j I C)'
Additional Comments:
Approved bJ~j)~ ~
)(
Date:
/~3;d'9
/
Contingent On Approval by Fire Marshall
Meet IBC, IPC, (MC and NEC Code Requirements
Sleeping Rooms below Story and in Basement required to have egress
x
For Office Use Only
Date Permit Paid: ..;2 - I!.I ~ 41
Permit Fee: ; 78 . tJ t/
Deposit Amount 6!otJ ' co
Receipt # d-tftJ ;?;l '>-'. j Jj
Deposit Paid by for return to: <:,j), A, 13o,r.;U....(A.,f
Building Inspection Pouch given: Yes V No_
/1;?'1 cr. /lwy 30
:P:dl /Ve; {j;gac?8
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska ,(:2.. 3Q
218 South 16th Street I ';> I I
Blair, Nebraska 68008
Fax (402) 426-4195 E 3076 .om
(402) 426-4191 ~
Permit Fee: $ ( 1)" /t; . () ()
Application Date:
?'1/~ ;;! & .- 0 cl
,
Job Address
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
1 st 1000 Amp Fee............... ...$195.00
Each additionall00 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.
2~2(~' OC
Date
[ NIl I D \- c.0 ~ u '-" '"
/ ~ I {ltJ {/f/}1
Phone
lZcl / it
Zip
Phone
o REMODELING/ADDITIONS 0 UPGRADE SERVICE
w all Ail cItJ:t c~
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 All Upgrades:
# of Circuits x $5.00 . z-.
Amp Fee
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x .063
Modular/Manufactured Homes..... ..$50.00
Other: (alterations, additions and modifications)
C'~
-
/0
Receptacles/Switches/Lighting Fixtures (110 volt only)
# of Apparatus.......... f/_ x $1.00 / '2
,.
co
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors..... 3
x $3.00
9-~
Permit Issuance Fee................. ..$25.00
Total '
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: 3- ;--~ f J/~
I
Rev. 2008-10
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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
CITY 0 r 5LAn~
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.
(
"- c--~
'--... ~ -~-
("~-' ---'-
'G<lRlfaetor~ . .
Owner/Occupant
City of Blair
(~l ~ '-07
Date
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci.blair.ne.us
EQU.l.tItO!JSlNG
OPPORTlHlITY
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
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 the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection being done.
6) Storm Water Management Plan inspection not obtained. (If Required)
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
,~\~5.-M
-- - --Contractor/Owner -~
City of Blair
~ -(\o'--'DCl
lJate
BUILDING INSPECTION REPORT
BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
NAME OF OWNER'
CONTRACTOR'
DATE INSPECTION REQUESTED'
TIME INSPECTION REQUESTED'
PERMIT NO'
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL PARTIAL
D STATUS CHECK
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP
D PARTIAL
PASSED FAILED
D D
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 RADIANT HEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: GROUNDWORK ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
DATE OF INSPECTION MADE:
FAXED OPPD\BURT REA
TO CONNECT SERVICE:
BUILDING INSPECTION REPORT
o
BLAIR
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION:
NAME OF OWNER'
CONTRACTOR'
DATE INSPECTION REQUESTED'
TIME INSPECTION REQUESTED'
PERMIT NO'
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK ROUGH-IN
PRESSURE TEST
o STATUS CHECK
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED FAILED
0 0
PASSED FAILED
0
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP
o PARTIAL
REMOTE 0 WATER SERVICE
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
FINAL 0 WATER METER INSTALLED 0 PARTIAL
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECT .
FAXED OPPD\BURTREA
TO CONNECT SERVICE:
BUILDING INSPECTION REPORT
",.
~ITY OF BLAIR ~O W AS~G'mN COUNTY 0 OTHER
LOCATIONOFINSPECnON.! \, if, YU~L~~ \r\ ~. I 3 t ;}. ( C/)UYlf'1..:/.. J2c1 (;)
.r~ U\.J~I\i"'" ~ U'~\-. I ~ '0v ,__
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NAME OF OWNER' {~J ~6Jp '. 17V:fi 'aA~ (\ \ \^'t:~:rRACTOR' J" /.:j. Vc.<Jl t,j~L!J
. \.:..1'\.1 '" V f - ~ 1 '" vV
DATE INSPECTION REQUESTED' ~~: - ;20 - () q TIME INSPECTION REQUESTED' / I .. 0 0 A . /14 . PERMIT NO' / 3 {.3 cr
TYPE OF. INSPECTION REQUESTED: 0 CONFERENCE
--. - =~ --..... --~~~'>I..._____ ~r~Ile'l~_
BUILDING: 0 FOOTING 0 DECKFOOTIN~RAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES:
PASSED FAILED
o 0
o SEWER TAP, 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
:', ~I
ELECTRICAL: 0 ROUGH IN 0 PINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
PASSED FAILED
o 0
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'-~
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
COMMENTS:
PASSED FAILED
o 0
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',,,-
PASSED FAILED ,.
.:~~
0' D
PLUMBI~m: 0 GROUNDWORK D ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
. . -,. . 0 PRESSURE TEST
bi~~1~Jt~~;~--cr~~ONJ)ITIONAL O.~..twANCYGRAN;---~'~
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02/2012009 11:12 AM
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)Zl CITY OF BLAIR
-- ~_u_~_..___ nUILDINGINSPECTION REPORT --~'~'--,-,~~-~ '...
o WASHINGTON COUNTY . 0 OTHER
/:-:5 / "'// /1 A\~ /~<
LOCATION OF INSPECTION' /~ --) /t/.:;;>} t t..;; / r ,(v
/'" --./f ' -.. ,.-~-----...
NAMEOFOWNER,iju;i/~.~/ &1?Ll:: CONTRACTOR' ~/) 1/
l /' /""
"2 ;"']~;? / /.-l -<,;7 II 'I j
DATE INSPECTION REQUESTED' ,~." /.]J:::"1 /' rYc-/, TIME INSPECTION REQUESTED' /7 / J (
I - ~ J
Llc~_'S'''u-1I!!J_L
/ --'? /.::< G7
PERMIT NO' /" -J I.....:.J 1
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE 0 STATUS CHECK
~ ~~ ....~.;:':"=~~~~~
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL D FINAL 0 PARTIAL PASSED FAILED
o 0
COMMENTS:
'"" ~~'t$.":'Z!f.~;Il..:2IiiO.!~,:'::::r.n\:E'"'~_~""",~ ~
~=~~'~""'''''''''''''''''''''~4
UTILITIES: 0 SEWER TAl? 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL'
COMMENTS:
.b.A"""~~Jr""'''~~_'''''''_'l:.''""~~~~.t="~~~~_.......,...._~~
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT PASSED FAILED
o PARTIAL 0 0
PASSED FAILED
o 0
,.';i
COMMENTS:
MECHANICAL:D'ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
PASSED
o 0
PLUMBJNG: 0 GROUNDWORK 0' Jt6UGI:J-rN
o PRESSURE TESTe'
CQMMENTS:'J'-~ ' ,- _ ,_ ~,,";'<":-',_ '_:--.: --:':'O;".':<~;_'_J;:'.' '_.." ,_, ,
-- ~~~ .",."..,..".~""'".,.,.,.,...- ~~~,
o OCCuPANCY GRANT~]j 0 Ef'e9~lti~~~bJ~~PWIWCX'GR.xNt~D /!1;/Y /' '.'
" " .. ,',!.. '~y.e/ -~'b '~ :>7 Pi <76:4 4(.
NOTESIREMiRKS' .., ,',,':;>; ,'I){l'?;:lfEi~~, ,,? /7;f::_/ ,1'/ .._~
. --,-," . '--"._~- ,..:~,~-.-,~""'c\_I;:~"~".._L~_,'._...-',;_-' -- ..
FINAL o WATER METER INSTALLED 0 PARTIAL
PASSED FAiLED,
o D
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"-j
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;~~ITY OF BLAIR
, -., ,.. "', ---
BlJIDDING INSPECTION REPORT
D WASHINGTON COUNTY
D OTHER
/ t1 -~ ' A
LOCATION OF INSPECTION' uJi!5{) J--71 Ci(A::l Adl 'aJ/ /CZ:AI{;. ..Ll---f .
NAME OF OWNER- iJ ;/7 (ll./U - (!~-1 ~i CONTRACTOR' (1 uM./Hl.Jl? uU a1./liJ
1 v
DATE INSPECTION REQUESTED' ;:;,.'), ell! ~ 01 TIME INSPECTION REQUESTED' It) .'t)tJ/J,'f-1 ' PERMIT NO' j 3/3 cr
TYPE OF INSPECTION REQUESTED: D CONFERENCE DSTATUS CHECK
~..Ilr-v-- ~ ~ __ ---~.._-- _~4~~Z=-~~
BUILDING: 0 FOOTING D DECK FOOTING 0 FRAMING D DRYWALL D FINAL D PARTIAL PASSED FAILED
D 0
UTILITIES: D SEWERTAf. D SEWER D SEPTIC D WATER TAP D REMOTE 0 WATER SERVICE
D PARTIAL'
PASSED FAILED
D 0
COMNIENTS:
"'~u:l!.:::! _.._.'_n"~._".",~"""""",, ~_,.
COMNIENTS:
ELECTRICAL: D ROUGH niJ21(FINAL D PERMANENT SERVICE
"';"'~ ~
D PARTIAL
SERVICE D PRECONNECT
FAILED
o
COMNIENTS:
MECHANICAL: 0 ROUGH-IN D NC D FURNACE 0 RADIANT HEAT D FINAL 0 PARTIAL
PASSED FAILED
D 0
PLUMBING: D D ROUGH-IN
o PRESSURE TEST
FINAL D WATERMETERINSTALLED 0 PARTIAL
PASSED FAILED
D 0
COMNIENTS:
o bCCUPA~;;-~6Ni)lfIbNALQ~~~~~
"C'"7............-
NOTES/REMARKS"
'--. ''''':~'',:-''':
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I / : ;;$
_'~."'__""_~_____C""-'-C.""'~~~'''''..,..-...._,..,.._~-''~'''''~''''''."..,..'_..,.-.''..-'~-~ ~ ~_ ".,~,~,_~. '~-~~';~-='~""~-;;7_''''ct-'~'''~'''''C''"''_:--_''~''':'7,.c.,_.C'~"""~'_''-''''''_''~=~'__''''''~' ~~'~'.'"--''''-._.c..~~<c~,,,
/'
/~
S.._CITY OF BLAIR 0 WASHINGTON COUNTY 0 OTHER
LOCATION OF INSPECTION- /~3 / ;} I (/~jC-(>l-1 f-C;./.- ;{?c/ / tv
(/1 ~l"" /i)'6l> / / if .,
NAME OF OWNER- . IJ/.i41 / c./U1-. ..;~.t' '0/ CONTRACTOR' I;<""YJ-'n c-?/~
DATE INSPECTION RE~UESTED' ,. -f~ ;;7 - Q CJ TIME INSPECTION REQUESTED- ,It? u tJ ,/1 l1' 'PERMIT NO'
/ ::< / ;:;? Q
~/,-) /
t
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE o STATUS CHECK
\;:""""'m'l~ - ""~"".... _~ -; a.. "'-=:s;.~
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL PASSED FAILED
o 0
COMMENTS:
~.""""'-,..~
~_m~~......=<io~~~~~~~~-==':l:~~
UTILITIES: 0 - SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
Pfl:( F~ED
o
COMMENTS:
~~~~""",,.._~.~~
MECHANICAL:D ROUGH"IN 0 NC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING:
PASSED FAILED
o 0
COMMENTS:.
o GRQUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED
D' PRE~SURE TEST
PARTIAL
PASSED FAILED
o 0
.~"'~-..
-.,.;~""""""""-~""""."'~
NOTES/REMARKS' .
I
l
f
..
t.
· -''1\
.,
BUILDING INSPECTION REPORT
o CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
,'; ."
DATE INSPECTION REQUESTED'
i ,. ,.. ., "".C""'L. :'
'55,09
f',\.
NAME OF OWNER'(
CONTRACTOR' .
/ ,(1 " ~ 11-_ i '
,) ,,';;
. ' .('.
TIME INSPECTION REQUESTED'
PERMIT NO'
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING 0 DECK FOOTING D FRAMING D DRYWALLE1.FINAL D PARTlAL
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC 0 WATER TAP D REMOTE D WATER SERVICE
o PARTIAL
D STATUS CHECK
PJ&) FOED
COMMENTS:
PASSED FAILED
o D
ELECTRICAL: D ROUGH IN"O:J5INAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANT HEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
J7~
DATE OF INSPECTION MADE:
6(~(~
TIME' 9' 6lJ
INSPECTO '
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY