BP13172Blair Building Pei "t Qetail
n i� fat
r F_ k
Permit #: 13172 Issued:
4/8/2009 Type: Residential Additions
Completed:
4/29/2010 Valuation: 51030
Location: 1120 Caddock St
Owner: Kristen Combs - Bicaba
Permit Fee: 627
Address: 1120 Caddock St
Issue Fee: 25
Deposit Amt.: 500
Blair, NE 68008
Receipt #: 24430
Phone: 402 533 8261
Section: Township:
Range:
Subdivision:
Lot: 52 Block: 4
18x19 kitchen addition with 18x26 full basement under and 26x18 wood deck off of kitchen addition and will add
egress window to existing bedroom in
basement.
Contractors
21st Century Builders
General Contractor Permit # Issued
CNJ Plumbing Inc
Plumbing Subcontractor P2013 6/8/2009
Getzschman Heating, LLC
Heating Subcontractor M1884 6/22/2009
TW Electric
Electrical Subcontractor E3105 5112/2009
Remarks
6/23/2009 KAR
Subject to Electrical, Mechanical and Plumbing Rough ins.
7/2/2009 KAR
Oppd Work with electrician on time of switch over. 305 -2303 cell office 733 -6580
7/14/2009 KAR
Disconnect for water heater required because it is out of site of main panel. Not can cath this
at final inspection you may go ahead and insulate and drywall.
7/30/2009 HOW
1. Provide access for inspection. call for re- inspection. -hw.
8/412009 HOW
1. scope: deck and cabez. - final- ok -hw.
8/412009 HOW
1. scope: insulation- ok -hw.
3/24/2010 BMP
Spoke to 21 st and he said he would get a hold of Kristen and have her call in for an
inspection.
3/26/2010 HOW
1. final inspection of project: approved - partial -needs elect final -call for final elect. inspection.
4/21/2010 KAR
Addition to back of house with basement. Outlet under deck has exposed wires need
finished wire material nutted or receptical and or cover plates. Disconnect for water heater?
No one home could not complete inspection.
Blair Building Permit Detail
Inspections
Date
By
4/2412009
KAR
Footings
Pass
6123/2009
KAR
Framing
Pass
6/30/2009
MARH
Footings
Pass
7/2/2009
KAR
Electrical Permanent Service
Pass
7/2/2009
KAR
Mechanical Rough -ins
Pass
7/2/2009
KAR
Electrical Rough -ins
Fail
7/2/2009
KAR
Plumbing Rough -ins
Fail
7/14/2009
KAR
Plumbing Rough -ins
Pass
7/14/2009
KAR
Electrical Rough -ins
Pass
7/30/2009
HOW
Conference
Fail
813/2009
HOW
Deck
Pass
8/3/2009
HOW
Framing
Pass
3/26/2010
HOW
Final Inspection of Project
Pass
3/26/2010
HOW
Mechanical Final
Pass
3126/2010
HOW
Plumbing Final
Pass
4/21/2010
KAR
Electrical Final
Fail
4/29/2010
KAR
Electrical Final
Pass
Partial
Date: 4-~.Oq
Site Plan Attached: /
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit:# \ ,3
Approximate Completion Date: l.;).3\-og
REScheck Attached:
Complete Plans Attached
Application for: Residential ~ Commercialjlndustrial_
New Construction Manufactured Home Modular
Move-on: Home _ Accessory Byj.kling 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 _
Job Address:
, lW Q., cLctcLrj(~.lc ,5+
f?J 9'e)() 6:~?5-tf1
Legal Description (if applicable)
Owner:K-n'sk VI LbvY\.b$'~ !b \U:JY'-Address: ?)3 Vv42 J
Contractor:~ \ 0-\.. ~ UULtlLY\J\ f:>lLl \ eLly\
\
Address: rt) \6st. \\J., NLe0.. dr0, JUS l.o~ oLt \
Phone#: 533 .-82-4? (
C
Phone #: 'N3r1
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
codesjordina es 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 0 I not completed within two (2) years of date of issue.
\.ci '~'~." /)/:!t~.
/,/Signat re of OwnerjConfractor
/"
/X
Date
1- 8'- D Cf.
ZONING REVIEW:
Zonin Flood Plain UtiI' .
Current Zoning:
Conditional Use Permit Required: Yes _ No
Date cu,/pproved:
Yes _ No, Variance Required: Yes _ No_
Second Front Side c-l Side _ Rear ~'~~
State Fire Marshal Required:
Minimum Setbacks: Front
Lot Sauare Footal'!e:
Length x Width:
Lot Coverage %
(lv'
Driveways/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:
NumbeLof Stories
~ '!
One -'-- Two _ Three
Four
>Four
High Rise (>75 ft)_
Type of ~esidential Structure:
Ranch ~ Two Story _ Split Entry _ Raised Ranch _ Other
Rooms _ Bedrooms _ Bathrooms _ Fireplaces _ Gas_ Electric _
Egress in Basement: Required: Yes X' No _ Provided on Plans: Yes l.. No_
.J ~
Sleeping Rooms ',:" Living Area Other Egress
f '
Sauare Footal'!e:
Main Level:
Basement: (Unfinished)
Garage:
Detached Garage:
Add" e"/Il'\ if" ( 5:' "/rT"
Itlon: ('.) jTl:i~ tol . (Ii '
.
Porch: Front Rear
Deck that affect setbacks: Rear
Second Level: Third Level
(Finished) 4ft:i €l
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front
Side
Occucancy 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 ,y::"
Is building reauired to be protected bv automatic fire sprinkler svstem?"
No ).(
-r--
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:
Iv fA
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:
Business/I nd ustrialjEd ucationalj Assembly/Factory/Storage/Util ity
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sqjft area X $63
Except for the following:
Accessory Buildim!s & Interior Remodeling Projects: 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 $2000)
Construction valuation computation:
Finished sqjft area
X$
$
Construction valuation is ...................................Permit fee is:
$0 TO $50....,......................................,.............. $0
$51 TO $500.,..........,.............,................,............$25
$501 TO $2,000........................................................$25 + $3 lJer 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
Issuance Fee:
$
(2 ry
o
Permit Fee calculate
Total Permit Fee == DE
$ 25.00
il 5~. 'J, (;,10
$ I ,~ 0<
C,"'(/
Additional Comments
Approved by:
'fjq /01
Contingent On Approval by
Meet IBC, IPC, IMC and NEI .-"'l-..-........."
Sleeping Rooms below Story and in Basement required to have egress
For Office Use Only
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
~
MECHANICAL PERMIT APPLICATION
I
I
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
).1 -1'" 0 ()l
Application Date: if ' ,J1' d - 7
Job Address
.l;Ieat Pump L3
It~ /ltmlilJA ~. _r::'
~_~/e o<'::'J
Tons
Tons
Furnace
BTUIH
AlC
# of Units
Furnace
Completion Date:
Boiler Chart
BTU Fee
Up to 100,000.............,.......... ".., ...$15.00
1 00,000-500,000, ..... ......,.. .. ...""... ...$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.
M 1884
Permit Fee: $ of).
at)
~ ~<
Zip
Phone
Zip
Phone
Iteration 0 Repair 0 Replacement
11-1 6i clcLitr~?v
MECHANICAL PERMIT FEES
c3tJ.
O(?
FurnaceIHeat Pump/Air Conditioner (Per Unit)
Up to and including 100,000 BTU / 3Ton..........................,,$15.00
FurnaceIHeat 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
ItJ-ff!O
/5.00
Duct System................................ ..$15.00
Gas/Air Outlets."".""."""First 5
x $6.00
... ... ".Additional
x $1.00
Radiant Heat Systems/Gas/Water
Piping System... .. . ......... ... ... ... ...... ..$50.00
It'~ Modular Home.................. ............. $50.00
O'--'U
b~a7'I-D 1
Date
Permit Issuance Fee..................... ".. .$25.00 !)5 - thJ
Total q. 00
Current License on File ~es 0 No 0 NjA
Comment:
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: ..ill < ?J I ~--'
I
Rev. 2008-10
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska '\. .2/ ~ '?-
218 South 16th Street ~....J
Blair, Nebraska 68008
Fax (402) 426-4195 P 2013
(402) 426-4191
Application Date: lj;.... 8 - 0 '1
Job Address
3. Class of Work:
Describe Work:
4.
Comments:
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.
I ('
\c...... ;)-
Date
"' ('
() '(
Permit Fee: $ t/7 00
c~ ddc (! f //1--
Zip
Phone
Zip
Phone
o Addition
, Alteration 0 Repair 0 Replacement
';;") /J
~~.:JdLr
PLUMBING PERMIT FEES
Modular Home... ... ... ... ...... ....$50.00
Type of Fixture No.
Kitchen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $12.00 x l
I d2 .~O
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..................... ....$1 0.00 x ~
Outside Water Faucet...................$6.00 x
Drinking Fountain........................$6.00 x_
/t!).OC)
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 (Commercia1)..$30.00
Gas/Water Piping System
(Commercial)................. .... ...$50.00
Permit Issuance Fee... ... .. .. ..... ..$25 .00
,;1 S'. C!&)
1 t:/ CJ
Current License on File
Comment:
Total
o NjA
DYes 0 No
WHEN PROPERLY V ALIDA TED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: /3. J'J/ I JA4~
Rev. 2008-10
R6 --0~
S/\~
IE
5 fJH1J
I <1 ~
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ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska . ,A'\~
218 South 16th Street V' .
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: 5' ~ I 2 -0 '1
Job Address
E 3105
Permit Fee: $
ItP/ (}3
ac/c&ei
Owner J/
1. I\.r/ e -om.s-
~~ntractoT W 6' J/ t! Zip
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL REMODELING/ADDITIONS
~~scribeWork: '-/JJIJ/fl cY~II.,t'efJ t:nld {!ba/~~
5.Current License on File ~ Yes 0 No 0 N/A Completion Date
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 ofIaws 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.
5-13-0
Date
Zip
s3~n~8~&1
Phone
1),E'I-(PS80
o UPGRADE SERVICE
pdd
ELECTRICAL PERMIT FEES
bl5 IJ ()
Upgrade Existing Service............ .$25.00
Temporary Service............... ..... $15.00
Fire Alarm System................. ....$15.00
Signs (each)... ................... ........$25.00
Miscellaneous Apparatus......... .....$15.00
Commercial/Multi Family and All Upgrades:
# of Circuits x $5.00
Amp Fee
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
8/0 sq. ft. x .063
Modular/Manufactured Homes...... .$50.00
Other: (alterations, additions and modifications)
Sj. () 3
Receptacles/Switches/Lighting 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
Comment:
Permit Issuance Fee...... .......... ...$25.00
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: cif ?JI-~
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 6800B
Krit>tml Comb..Bi~\l!.ba
lUG C~ddock Street
LQ)l BI6€:k 41 Fab"'Vi~w
County
NAME;
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DATE: JllliJlt1: 9. 2006
Job
-- -Truss
Truss Type
Qty m Ply
JOBS
MEAD
SCISSORS
1
. --.dQll... Reference (optional)
7,050 s May 22 2008 MiTek Industries, Inc. Man Apr 06 15:48:082009 Page 1
- Advanced Building & Componenls, Inc.. Mea-d, NE
68041, Sco'U -Rowell
-.1-10-8 -
1-1 0-8
5-7-7
5-7-7
10-0-0
4-4-9
14-4..9
4-4-9
20-0-0
5-7-7
21-10-8
1-10-8
Scale "'-1:335
5'~6 -
0>.
€b.B
3'4
W-I 1l
-ws
T2
-
B2
BZXJ
N
,f.;
c,
500.'12
-Sx4
"
\'.'2
*
Wt~
Tl
.,
10
"'4
~
;J.{lOI2
;~
4x8-
4"
0-3-8(0-1-13)
0-:J.8{O-1-J3)
5-7-7
5-7-7
Efat:.:<21fSe;tS(gLY): [2:0:3:12~~2:Oj~ l6:0-3-12,O-2,-gj.
10-0-0
4-4-9
14-4-9
4-4-9
20-0-0
5-7-7
lOADING(psf)
TClL 30.0
TCDL 10,0
BCLL 0,0
BCDL 10.0
SPACING 2-0-{)
Plates Increase 1.15
lumber Increase 1.15
Rep Stress Incr YES
Code IRC2006TfPI2002
CSI
TC 0.36
BC 0:45
WB 0:47
(Malrix)
DEFl
Vert(LL)
Vert(TL)
Horz(TL)
in (Ioc)
-0.29 8-9
-0.60 8-9
0:40 6
IIdefl
>804
>394
n/a
Lid
240
180
n/a
PLATES GRIP
MT20 197/144
Weight: 66 Ib
lUMBER
TOP CHORD 2 X 4 SPF 2400F 2.0E
BOT CHORD 2 X 4 SPF 2400F 2.0E
WEBS 2 X 4 SPF No.2
REACTIONS (Ib/size) 2=928/0-3-8,6=928/0-3-8
Max Horz2=-58(LC 9)
Max Uplift2=-197(LC 8). 6=-197(LC 9)
Max Grav2=1147(lC 2), 6=1147(LC 2)
BRACING
TOP CHORD
BOT CHORD
Structural wood sheathing directly applied or 3-8-7 oc purl ins.
Rigid ceiling directly applied or 10-0-{) oc bracing.
FORCES (Ib) - Maximum Compression/Maximum Tension
TOP CHORD 1-2=0170,2-3=-3975/438,3-11=-3058/262, 4-11=-3044/282, 4-12=-3044/290,5-12=-3058/269,5-6=-3975/362,6-7=0170
BOT CHORD 2-10=-384/3667,9-10=-385/3679, 8-9=-269/3679, 6-8=-270/3667
WEBS 3-10=0/177, 3-9=-917/221, 4-9=-111/1908, 5-9=-917/233. 5-8=0/177
NOTES
1) Unbalanced roof live loads have been considered for Ihis design.
2) Wind: ASCE 7-05; 90mph; TCDl=6.0psf; BCDL=6.0psf; h=25ft; Cat. II; Exp B; partially; MWFRS (low-rise) gable end zone; canlilever left and right exposed
; end vertical left and right exposed; Lumber DOl=1.33 plate grip DOl=1.33
i 3) TCLL: ASCE 7-{)5; Pr=30.0 psf (roof live load: Lumber DOL=1.15 Plate DOL=1.15); Pg=30.0 psf (ground snow); Pf=20.8 psf (flat roof snow: lumber
, DOL=1.15 Plate DOL=1.15); Category II; Exp B; Fully Exp.; Ct=1.1
4) Unbalanced snow loads have been considered for this design.
5) This truss has been designed for greater of min roof live toad of 16.0 psf or 2.00 times flat roof load of 20.8 psf on overhangs non,concurrent with other live
loads.
6) This truss has been designed for a 10.0 psf bottom chord live load nonconcurrent with any other live loads.
7) Bearing atjoint(s) 2, 6 considers parallel to grain value using ANSITfPI1 angle to grain formula. Building designer should verify capacity of bearing surface.
8) One H2.5A Simpson Strong-Tie connectors recommended to connect truss to bearing walls due to uplift atjt(s) 2 and 6.
9) This trllSS is designed in accordance with the 2006 International Residential Code sections R502.11.1 and R802.10,2 and referenced standard ANSITfPI1.
lOAD CASE(S) Standard
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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.
} ."/-1
\ .' (/':;l/~' j[<:~G{Z~::~,>/~
Contractor/Owner
Contractor/Owner
City of Blair
Date
BUILDING INSPECTION REPORT
CITY OF BLAIR
D W ASHlNGTON COUNTY D OTHER
LOCATION OF INSPECTION'
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PERMIT NO'
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NAME OF OWNER' / (f/;';~{I.L._ ~.
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DATE INSPECTION REQUESTED,t! ,::,) L/ 0 (J' TIME INSPECTION
TYPE OF INSPECTION REQUESTED: t~( ~f~ D CONFERENCE
BUILDING: FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
~ F~ED
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
D PARTIAL
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 NC 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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INSPECTO '
DATE OF lNSPECTION MADE: [)y-~y~ TIME,9-',;20
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
,O<CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
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DATE INSPECTION REQUESTED' CO,;;;:)) (iC:( TIME INSPECTION REQUESTED' i I ::::) () {\ if' ii, . ' PERMIT
TYPE OF INSPECTION REQUESTED:
BUILDING: D FOOTING D DECK FOOTING
DCONFERENCE
FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
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 A/C D FURNACE D RADIANT HEAT 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
NOTES/REMARKS'
ATE OF INSPECTION MADE:
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INSPECTO .
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
CITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
NAME OF OWNER- (~e C! Vi", b s f), (';1 ~>f)1
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DATE INSPECTION REQUESTED'
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TIME INSPECTION REQUESTED'/ L/.
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWERTAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
COMMENTS:
~LECTRICAL: M ~l~ 0 FINAL \[;J"PERMANENT SERVICE 0 TEMPORARY SERVICE~ PRECONNECT
]:'/>>. ;.(t!C1 0 PARTIA0- -r"
COMMENTS: ~ ~
6M~CHA:NICAI:.;0(~OUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
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COMMENTS:
PASSED FAILED
o 0
PASSED FAILED
o 0
~D F~ED
~ED
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o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS' o'fi{) Wo-r'k ,<,.1ft{ R:/&:tf/~flq,#7 ~ -fl~pt~ df2- Std/tf~
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PASSED FAILED
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INSPECTOR q{rukJc<: -ef~::o ~ DATEOP INSPECI10NMADE, 0 7-o:;;Z~ TIME- LO: i? S
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
[J<CITY OF BLAIR
".
BUILDING INSPECTION REPORT
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o WASHINGTON COUNTY
o OTHER
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DATE INSPECTION REQUESTED' liP " <~>!~ ~ e) '}
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TIME INSPECTION REQUESTED~
PERMIT NO'
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: FOOTING 0 DECKFOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
~ED F3'ED
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
MECHANICAL: 0 ROUGH-IN 0 A/C 0 FURNACE 0 RADIANT HEAT
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN,:~!!IFINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR- /(\twlL fJ ~
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DATE OF INSPECTION MADE: & / ? oj ~
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FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
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LOCATION OF INSPECTION'
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
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NAME OF OWNER'
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DATE INSPECTION REQUESTED' I
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TIME INSPECTION REQUESTED' I' (./,
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
PASSED FAILED
o 0
FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING:
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED
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o GROUNDWORK 1~::ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
p~ FAILED
)l5-' 0
NOTES/REMARKS'
DATE OF INSPECTION MADE: 07- r/JV~ TIMR' J' j. ~
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
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D CITY OF BLAIR
BUILDING INSPECTION REPORT
D WASHINGTON COUNTY
D OTHER
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NAME OF
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TIME INSPECTION REQUESTED'
PERMIT NO'
DATE INSPECTION REQUESTED-
TYPE OF INSPECTION REQUESTED: "..EJ:',(:ONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
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 RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
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INSPECTOR' ;st~~
FAXED OPPD\BURT REA
DATE OF INSPECTION MADE: 7 ~. '3 (J - 0 ..,}
TIMF' S :~
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
D CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
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NAME OF OWNER I" i j '/VL b ./
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CONTRACTOR'
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DATE INSPECTION REQUESTED'
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TIME INSPECTION REQUESTED'
PERMIT NO' / 3 I ? :,;\.,'
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: FOOTING D DECK FOOTING D FRAMING D DRYWALL \~, FINAL D PARTIAL
D STATUS CHECK
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP 0 REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
l
'~'r D
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
o D
COMMENTS:
MECHANICAL:O ROUGH-ru D NC D FURNACE D RADIANTHEAT D FINAL 0 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:
o OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
D D
NOTES/REMARKS'
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
` ❑c CITY OF BLAIR ❑ WASHINGTON COUNTY ❑OTHE
LOCATION OF INSPECTION
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NAME OF OWNER 'CONTRACTO ✓ ;J ✓ ` ' ` .,. ?-
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DATE INSPECTION REQUESTED ` .. a" TIME INSPECTION REQUESTED I. s "° PERMIT NO
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL<❑ FINAL PARTIAL
PASSED FAILED
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
❑
COMMENTS:
v e L d
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH INAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
F
PARTIAL
❑
COMMENTS:
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT e. • .. , FINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
-N�
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS -
INSPECTO
.DATE OF INSPECTION MADE:
r C T IME:
- 30 wvL
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION RE
CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE i
LOCATION OF INSPECTION
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NAME OF OWNER ' CONTRACTO
DATE INSPECTION REQUESTE TIME INSPECTION REQUESTED A PERMIT NO
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TY PE OF INSPECTION REQUESTED: ��� � �,` C ❑ CONFERENCE Ll S TATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED
El 1:1
COMMENTS
UTILITIES: ❑ SEWER f
❑ PARTIAL
COMMENTS:
❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED FAILED
❑ ❑ a
ELECTRICAL: ❑ ROUGH K,9.,TINAL ❑ PERMANENT SERVICE F] TEMPORARY SERVICE El PRECONNECT PASSED FAILED
❑ PARTIAL ❑
COMMENTS:
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED
❑ ❑
COM MENTS:
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
❑ PRESSURE TEST ❑ ❑
COMMENTS:
❑ OCCUPANCY ANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMA // ` �' 1 �/ d'r✓
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INSPECTOR DATE OF INSPECTION MADE: ® ` c2� / �'! W T IIyTF
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
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'"BUILDING INSPECTION REPORT
OF BLAIR
F WASHINGTON COUNTY ❑ OTHER
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LOCATION OF INSPECTION
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NAME OF OWNER
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DATE INSPECTION REQUESTED
TIME INSPECTION REQUESTED
PERMIT N
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑
FOOTING F DECK FOOTING
❑ FRAMING ❑ DRYWALL ❑
FINAL F PARTIAL
PASSED FAILED
❑ F
COMMENTS:
UTILITIES: F
SEWER TAP ❑ SEWER
❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED FAILED
F
PARTIAL
❑ ❑
COMMENTS:
ELECTRICAL: F ROUGH IN FINAL F] PERMANENT SERVICE ❑ TEMPORARY SERVICE El PRECONNECT PASSE AILED
F1 PARTTAL?� o") ❑
COMMENTS:
MECHANICAL: F ROUGH-IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
COMMENTS:
PASSED FAILED
❑ F
PLUMBING: ❑ GROUNDWORK F ROUGH-IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
❑ PRESSURE TEST
COMMENTS:
----- ------
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED