BP13149
Permit #: 13149 Issued:
Completed:
Location: 11377 Bridgeview Dr
Owner: Bob & Susan Juza
Address: 11377 Bridgeview Dr
Blair, NE 68008
Phone: 426 8085
Section:
Township:
Subdivision: OAK PARK I
i,,' \ U
Blair Building Permit Detail
2/19/2009
3/17/2009
Type: Accessory Building
Valuation: 24750
Range:
Lot: 6
24 x 30 Pole Barn with lean to attached one over head door.
Contractors
Astro Buildings, Inc.
Remarks
Inspections Date
2/25/2009
3/17/2009
By
OEM
OEM
General Contractor
Footings
Final Inspection of Project
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit #
Pass
Pass
366
25
500
24062
Issued
CITY OF BLAIR - APPLICATION FOR BUilDING PERMIT
Permit #
Date: c9-1} q loC1 /
Site Plan Attached: ~
Approximate Completion Date:
4(1
3{31! OCt
RESche~ttached: Complete Plans Attached
Application for: Residential L Commercial/Industrial _
New Construction Manufactured Home Modular
Move-on: Home _ Accessory Building Other
Remodel Addition ~/~
Accessory Building: Gara~e _ Pole B.arn~ Other
Floor Type: Dirt _ Concrete ~ Electricity: Yes _ No ~
Sign Erecting, Awnings _ Decks/Handicap Ramps (plot plan required) _
Satellite Dishes/Radio Antenna Cell Towers Jot nlan r quired)_
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 _
Addition~1 D:~cription o.~project if necessary~L\'{20 I:) I
'Cfl...e.. o"v"C. If' h...o cuJ c\.D'Dr'Z
.~~~ X~C)
l.ean to .AHCL~C{
Proiect Information:
r
c-
Job Address:
\ \31 \
-e.,\'t cI~ e. ',[1 e~ill 'biZ 89 ()() '1':5 ;2 2 v
M ~ OoJ~ ?OveJ( fi(~+ f+[d,+r(jy~
Legal Description (if applicable)
lL ')
Owner:,tvb iSl &\n J{ ,l1,CA.- Address: Sd\J\JL
Contractor: ASiYD ,f"}JLl"v oli,ncf
Address:~{)to SfJ1LH1 tJ'}ni&f -{)rnaltc~ t.;~ /ifL/
Phone#:~Cf . ~6'3S~:.,~~1f~
Phone'#:l.& N ,sqf.t;<.r
'p
Gett-#: · ').r~AryLZ-
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 complete~ within two (2) years of date of issue.
?( (?}ft:
Signature of Owner! ' ontractor
~k
,:2fll~,./ cC :;
,
Date
ZONING REVIEW:
Zonin Flood Plain Utilities:
Current Zoning:
Conditional Use Permit Required: Yes _ No \,/
Date cU~proved: ~
State Fire Marshal Required: Yes _ No Variance Required: Yes _ No_
Minimum Setbacks: Front ~-second Front Side -q- Side -9- Rear~
Lot Sauare Foota~e:
Length x Width:
Lot Coverage %
(S L--
Drivewavs/Sidewalks: \\ \fuf:
Sidewalk required: Yes_ No ~f Sidewalk Waiver: Yes _ No
Date Waiver Approved:
Preexisting Garage requires driveway to be less than 3' from property line: Yes_
Approved by:
Flood Plain: Yes No ~
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
36 7 b 50.8'0<073 GCJ, +t.
-to ~i - Lir~eL ,
\:1(~ 15 c~rcd b ,
7W1WI mtMn \200 ~J;:r iI.
Number of Stories
One Two
Th ree
Four
>Four
High Rise (> 75 ft) _
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
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
Occupancv 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 buildinl'! 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 13D
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:
Buildinl'! 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:
Perm it 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:
Business/I nd ustrial/Ed ucational/ Assem bly/Factory /Storage/Utility
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sqjft area X$63
Except for the following:
Accessory Buildin~s & Interior Remodeling Proiects: sqjft area X $43
Pole barns with no hard surface floor: sqjft area X $25
Si~n Erectin~Awnings and Decks/Handicap Ramps: sqjft area X $25 (Minimum
valuation of $2000) v ('j
X$.
Construction valuation computation: (;'90
Finished sqjft area '1 _
$
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
$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
Permit Fee calculated from chart above
$ ,,::) /iJ IiJ . (, (J
Issuance Fee:
$
25.00 -
(1/ ('0
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
$ /35<{/. ()O
Additional Comments:
hYo ;04 :L7/s PJ?C;;;;:) . ~~ nj)
.
..r-_ __
Approved b~.. 7)a// ti~~
p2~O ~9
E t?
Contingent On Approval by Fire Marshall . ,0
Meet IBC, IPC, IMC and NEC Code Requirements J<
Sleeping Rooms below Story and in Basement required to have egress
For Office Use OnJy
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
(i.l,
PfJWE:R TD F'E:RFORM.
MiTek Industries, Inc.
14515 North Outer Forty Drive
Suite 300
Chesterfield, MO 63017-5746
Re: To Build
The truss drawing(s) referenced below have been prepared by MiTek Industries, Inc. under my direct supervision
based on the parameters provided by R & D, Omaha.
Pages or sheets covered by this seal: 115030344 thm 115030345
My license renewal date for the state of Nebraska is December 31,2009.
February 10,2009
Fox, Steve
The seal on these drawings indicate acceptance of professional engineering responsibility solely for the
truss components shown. The suitability and use of this component for any particular building is the
responsibility of the building designer, per ANSI/TPI-2002 Chapter 2.
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Truss Type
ATTIC
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Roberts & Oybdahl, Omaha, NE 68108
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1 PO #023-90
Job Reference 0 tional
7.060 s Jan 22 2009 MiTek Industries. Inc.
1150303441
I
Mon Feb 0916:07:002009 Page 1
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15-11,8
4-1-0
161?-4
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10
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3.2-4
Plale Offsets ex n [4'04.80-2-01 16'04-80-2-01 19'0-3-80-641 111'0-3.80-641
23.9-0
4-6-8
----1
Scale 0 1 :46.3
[~
9x10 MT18H =
, , , ,
LOADING (pst) SPACING 7-6-0 CSI DEFL in (Ioc) I/defl Ud PLATES GRIP
TCLL 20,0 Plates Increase 1.15 TC 0.28 Vert(LL) -0.22 9-11 >999 360 MT20 197/144
TCDL 4.0 Lumber Increase 1.15 BC 0.59 Vert(TL) -0.32 9-11 >874 240 MT18H 197/144
BCLL 0.0 Rep Stress Incr NO WB 0.80 Horz(TL) 0.07 8 nla nla
BCDL 3.0 Code IBC2006fTPI2002 (Matrix) Weight: 233 Ib
LUMBER
TOP CHORD
BOT CHORD
WEBS
2 X 10 SYP 2400F 2.0E
2 X 10 SYP 2400F 2.0E
2 X 4 SPF 1650F 1.5E 'Except*
4-6: 2 X 4 SPF 2100F 1.8E, 5.12: 2 X 6 SPF 1650F 1.5E
REACTIONS (Ib/size) 2=3454/0-5-8,8=3299/0-5-8
Max Horz 2=203(LC 7)
Max Grav 2=4234(LC 2), 8=4001 (LC 2)
BRACING
TOP CHORD 2-0-0 oc purlins (4-6-6 max.).
BOT CHORD Rigid ceiling directly applied or 10-0-0 oc bracing.
JOINTS 1 Brace at Jt(s): 5, 12
GRAPHICAL PURLlN REPRESENTATION DOES NOT DEPICT THE SIZE OR THE ORIENTATION
OF THE PURLlN ALONG THE TOP ANDIOR BOTTOM CHORD. PURLlNS MUST BE
DESIGNED BY OTHERS FOR SIZE, AND POSITIONED IN SUCH A WAY AS TO SUPPORT
THE IMPOSED LOAD ALONG THE CLEARS PAN OF THE PURLlN.
THIS DRAWING ASSUMES NO RESPONSIBILITY FOR THE DESIGN OF THE LATERAL BRACING
SHOWN. DUE TO THE WIDE SPACING OF THE TRUSSES, SPECIAL CONSIDERATIONS MUST BE
GIVEN IN THIS AREA. IT IS THE RESPONSIBILITY OF THE PROJECT ENGINEERJARCHITECT
TO SPECIFY PROPER BRACING SIZE AND ATTACHMENT.
FORCES (I b) - Max. Comp.lMax. Ten. - All forces 250 (Ib) or less except when shown.
TOP CHORD 2-3=-7582/0,34=-7225/0,4-13=-2653/0, 5-13=-2353/0, 5-14=-2349/0, 6-14=-2651/0,
6-7=-7232/0,7-8=-7612/0
BOT CHORD 2-11=0/6356,10-11=0/6399,9.10=0/6399,8.9=0/6393
WEBS 4-12=-4049/0,6-12=4049/0,4-11=0/1970, 6-9=011994. 3-11=-364/746, 7-9=-402/731,
5-12=0/874
NOTES
1) Unbalanced roof live loads have been considered for this design.
2) Wind: ASCE 7-05; 90mph; TCDL=4.0psf; BCDL=3.0psf; h=25ft; Cat. I; Exp B; enclosed; MWFRS (low-rise); cantilever left and right
exposed; end vertical left and right exposed; Lumber DOL=1.60 plate grip DOL=1.60 (Actual dead loads used per ANSlfTPI 1 - 2002
section 6.2.1.3)
3) TCLL: ASCE 7-05; Pr=20.0 psf (roof live load: Lumber DOL=1.15 Plale DOL=1.15); Pg=25.0 psf (ground snow); Ps=11.9 psf (roof snow:
Lumber DOL=1.15 Plate DOL=1.15); Category I; Exp B; Fully Exp.; Ct=1.2; Unobstructed slippery surface
4) Roof design snow load has been reduced to account for slope.
5) Unbalanced snow loads have been considered for this design.
6) This truss has been designed for greater of min roof live load of 16.0 psf or 2.00 times flat roof load of 15.1 psf on overhangs
non-concurrent with other live loads.
7) The bottom chord dead load shown is sufficient only to cover the truss weight itself and does not allow for any additional load to be added
to the bottom chord.
8) Dead loads shown include weight of truss. Top chord dead load of 5.0 psf (or less) is not adequate for a shingle roof. Architect to verify
adequacy of top chord dead load.
9) All plates are MT20 plates unless otherwise indicated.
10) Ceiling dead load (3.0 pst) on member(s). 4-12, 6-12
11) Bottom chord live load (40.0 pst) and additional bottom chord dead load (10.0 pst) applied only to room. 9-11
12) This truss is designed in accordance with the 2006 International Building Code section 2306.1 and referenced standard ANSlfTPI 1.
13) Attic room checked for U360 deflection.
LOAD CASE(S) Standard
A WARNTNG. V~d.fY dt.--sign pat'omd.....rs and READ NOTES ON 1lUS AND INCLUDED MlTEK REFERENCE PAGE ].nl.747~1 !"ell. 10.'08 BEFORE USE.
Design valid for use only with MiTek connectors. This design is based only upon parameters shown, and is lor an individual building component.
Applicability of design poramenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown
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fabrication, quality control. storage, delivery. erection and bracing. consult ANSI/TPI1 Quality Criteria, OSB.89 and BCSI Building Component
Safety InformaHon available from Truss Plate Institute. 781 N. Lee Street Suite 312, Alexandria. VA 22314.
February 10,2009
14515 N. Outer Forty, Suite #300
Chesterfield, MO 63017
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ITO_BUILO PO_023A GABLE 2 1 PO #023.90 1150303451
i i Job Reference (ootional) 1
Roberts & Oybdahl. Omaha, NE 68108
7.060 s Jan 22 2009 MiTek Industries, Inc. Man Feb 0916:07:012009 Page 1
i-1-O-O i
1-0-0
4-6-8
4-6-8
7,8-12
3.2-4
7'~8
0-0.12
11,10-8
4+0
15-11-8
4-1-0
16i-4
0.0,12
19,2-8
3.2-4
23,9,0
4-6-8
---1
Scale = 1'46.3
9x10 MT18H
m1
6.00 112
3x6 II
3x6 -:;.
I~
9x10 MT18H =
11
10x12 =
10
9x10 MT18H = 10x12 =
9x10 MT18H =
4,6,8
4,6-8
7,8,12
3-2-4
16,0.4
8,3,8
19.2.8
3-2.4
23-9,0
4.6,8
Plate Offsets IX y). 19'0-3-80-6-41 [11'0-3-80-6.41 113'0-1-80-0-01 [16'0-1-80-0-01
, , , , , ,
LOADING (psI) SPACING 3,9-0 CSI DEFL in (Ioc) Ildeft L/d PLATES GRIP
TCLL 20.0 Plates Increase 1.15 TC 0.12 Vert(LL) -0.11 9-11 >999 360 MT20 197/144
TCDL 4.0 Lumber Increase 1.15 BC 0.29 Vert(TL) -0.16 9-11 >999 240 MT18H 197/144
BCLL 0.0 Rep Stress Incr NO WB 0.22 Horz(TL) 0.04 8 nla nla
BCDL 3.0 Code IBC2006fTPI2002 (Matrix) Weight: 253 Ib
LUMBER
TOP CHORD
BOT CHORD
WEBS
2 X 10 SYP 2400F 2.0E
2 X 10 SYP 2400F 2.0E
2 X 4 SPF 1650F 1.5E 'Except'
4-6: 2 X 4 SPF 2100F 1.8E, 5-12: 2 X 6 SPF 1650F 1.5E
2 X 4 SPF 1650F 1.5E
BRACING
TOP CHORD 2-0-0 oc purlins (6-0-0 max.).
BOT CHORD Rigid ceiling directly applied or 10.0-0 oc bracing.
JOINTS 1 Brace at Jt(s): 5,12
GRAPHICAL PURLlN REPRESENTATION DOES NOT DEPICT THE SIZE OR THE ORIENTATION
OF THE PURLlN ALONG THE TOP ANDIOR BOnOM CHORD, PURLlNS MUST BE
DESIGNED BY OTHERS FOR SIZE, AND POSITIONED IN SUCH A WAY AS TO SUPPORT
THE IMPOSED LOAD ALONG THE CLEARSPAN OF THE PURLlN.
OTHERS
REACTIONS
(Ib/size) 2=172710-5-8,8=165010-5.8
Max Horz 2=122(LC 7)
Max Uplift2=-92(LC 7), 8=-21(LC 8)
Max Grav 2=2117(LC 2), 8=2001(LC 2)
THIS DRAWING ASSUMES NO RESPONSIBILITY FOR THE DESIGN OF THE LATERAL BRACING
SHOWN. DUE TO THE WIDE SPACING OF THE TRUSSES, SPECIAL CONSIDERATIONS MUST BE
GIVEN IN THIS AREA. IT IS THE RESPONSIBILITY OF THE PROJECT ENGINEER/ARCHITECT
TO SPECIFY PROPER BRACING SIZE AND ATTACHMENT.
FORCES (I b) - Max. Comp.lMax. Ten. - All forces 250 (Ib) or less except when shown.
TOP CHORD 2-3=-3791/0, 3-4=-361310, 4-20=-1326/38, 5-20=-1176/63, 5-21=-1175/61, 6-21 =-1326/36,
6-7=-3616/0,7-8=-3806/0
BOT CHORD 2-11=0/3178, 10-11=0/3199, 9-10=0/3199, 8.9=013197
WEBS 4-12=-2025/0,6.12=-2025/0,4-11=0/985, 6-9=01997, 3.11=-182/373, 7-9=-2011366.
5-12=0/437
NOTES
1) Unbalanced roof live loads have been considered for this design.
2) Wind: ASCE 7-05; 90mph; TCDL=4.0psf; BCDL=3.0psf; h=25ft; Cat. I; Exp B; enclosed; MWFRS (Iow.rise) gable end zone; cantilever left
and right exposed; end vertical left and right exposed; Lumber DOL=1.60 plate grip DOL=1.60 (Actual dead loads used per ANSlfTPI1-
2002 section 6.2.1.3)
3) Truss designed for wind loads in the plane of the truss only. For studs exposed to wind (normal to the face), see Standard Industry Gable
End Details as applicabie, or consuit qualified building designer as per ANSlfTP11-2002.
4) TCLL: ASCE 7-05; Pr=20.0 psf (roof live load: Lumber DOL=1.15 Plate DOL=1.15); Pg=25.0 psf (ground snow); Ps=11,9 psf (roof snow:
Lumber DOL=1.15 Plate DOL=1.15); Category I; Exp B; Fully Expo; Ct=1.2; Unobstructed slippery surface
5) Roof design snow load has been reduced to account for slope.
6) Unbalanced snow loads have been considered for this design.
7) This truss has been designed for greater of min roof live load of 16.0 psf or 2.00 times ftat roof load of 15.1 psf on overhangs
non-concurrent with other live loads.
8) The bottom chord dead load shown is sufficient only to cover the truss weight itself and does not allow for any additional load to be added
to the bottom chord.
9) Dead loads shown include weight of truss. Top chord dead load of 5.0 psf (or less) is not adequate for a shingle roof. Architect to verify
adequacy of top chord dead load.
10) All plates are MT20 plates unless otherwise indicated.
11) Horizontal gable studs spaced at 2-6-0 oC.
12) Ceiling dead load (3.0 psI) on member(s). 4-12, 6,12
13) Bottom chord live load (40.0 psI) and additional bottom chord dead load (10.0 psf) applied only to room. 9-11
Continued on page 2
February 10,2009
A. WARNING.. V~,.;fy desigfl paramefers and READ NOTES ON l1lfSAND INCLUDED MlTEK REFERENCE PAGE ].1[/.7473 l'ell. 10.'08 BEFOI?E USE.
Design valid for use only with MiTek connectors. This design is based only upon parameters shown, and is for an individual building component,
Applicability of design paramenters and proper incorporation of component is responsibility of building designer - not truss designer. Bracing shown
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fabrication, quality control, storage, delivery, erection and bracing. consult ANSI/TPI1 Quality Criteria. OSB.89 and BCSI Building Component
Safety Information available from Truss Plate Institute. 781 N. Lee Street. Suite 312. Alexandria, VA 22314.
14515 N. Outer Forty, Suite #300
Chesterfield, MO 63017
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Job Truss Truss Type Qty Ply
115030345
TO_BUILD PO_023A GABLE 2 1 PO #023-90
Job Reference lontional\
Roberts & Dybdahl, Omaha. NE 68108
7.060 s Jan 22 2009 MiTek Industries, Inc. Mon Feb 0916:07'02 2009 Page 2
NOTES
14) Provide mechanical ConnectiOn (by others) of truss to bearing plate capable of withstanding 92 Ib uplift at joint 2 and 211b uplift at joint 8.
15) This truss is designed in accordance with the 2006 International Building Code section 2306.1 and referenced standard ANSIITPI 1.
16) Graphical purlin representation does not depict the size or the orientation of the purlin along the top and/or bottom chord.
17) Attic room checked for U360 deflection.
LOAD CASE(S) Standard
A WARNING. Vffify d,"'gn pummel",,, and READ M)TES ON rnlSAND INCLUDED MITEK IIBFERENCE PAGBM[[.747:i1 eel'. 10.'08 DEFORE USE.
Design vo~d for use only with MiTek connectors. This design is based only upon parameters shown. and is for an individual building component.
Applicability of design paromenters and proper incorporation of component is responsibmty of building designer - not truss designer. Bracing shown
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fabrication. quality control, storage, delivery, erection and bracing. consult ANS1/TPI1 Quality Criteria. OS8.89 and SCSI BuildIng Component
Safety InformaHon available from Truss Plate Institute. 781 N. lee Street. Suite 312. Alexandria. V A 22314.
I'
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p,i'Wi';,ropi.;t;iiRM.
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BtJILI>ING INSPECTION REPORT
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Q'" CITY OF BLAIR 0 WASHINGTON COUNTY 0 OTHER
r LOCATION OF INSPECTION- \ L~ "1 (~~ i d 9!,,-..V \ t,/W qdrl
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, NAME OF OWNER-l.~..~~ Y / '-t '..,.)'C.-I..-~~ \ ___y,-,~Lc::.. CONTRACTOR' !-\'Q\YV G)\.~k1l. C \ I (/V'-
DATE INSPECTION REQUESTED- ~-I ?S lrj.:f TIME INSPECTION REQUESTED' l t). :5'..,) PE~T NO- L:S ( l~i
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
~~ILDING: . \EiFOOTING -D-;~CKFOOT;G 0 FRAMING 0 DRYWALL 0 ~~~ -0 PARTIAL
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o STATUS CHECK
COMMENTS:
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o 0
PLUMBING: 0 GROUNDWQRK 0 ROUGH-IN D FINAL D WATERMETERINSTALLED 0 PARTIAL PASSED FAILED
o PREssuIlli'TEST D D
COMMENTS:.
~ ~~~ .t~"""""~"""'''' '''''t
o OCCUP~N6YGRANrED It] C6Npitl0NKi~'~cC,yPANC;tG'RANTED
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BUILDING INSPECTION REPORT
i CITY OF BLAIR D WASHINGTON COUNTY D OTHER
/137"- Op \~''l~_
LOCATION OF INSPECTION' I,' 1 K~) !', t t'.:{:'L VI L U-.J ~ \"" ~
NAME OF OWNER- ~ 7=: f). CONTRACTOR-
DATE INSPECTION REQUESTED- :.3 Ii '''1 / Q 9 TIME INSPECTION REQUESTED' I' () .' DO A '1\'.1. PERMIT NO' /.;3 / (1- q
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TYPE OF INS,PECTION REQUESTED: D CONFERENCE
--BUILDING: D FOOTING D" DECK FOOTING D FRAMING D DRYWALL/JZJ;INAL D PARTIAL
COMMENTS:
UTILITIES: SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
D STATUS CHECK
ftrD F~ED
COMMENTS:
PASSED FAILED
D D
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ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
COMMENTS:
PASSED FAILED
D D
MECHANICAL: ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
COMMENTS:
PASSED FAILED
D D
~--.,..,."
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
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D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
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