BPM1869
nspections
Date
5/21/2009
By
KAR
Final
nspection of Project
Pass
Remarks
Washington County Heating & NC
nc.
General Contractor
Perm
it
#
ssued
Contractors
4 Ton AC unit.
Subdivision
Range
Lot: 3
Block
Section
Phone
Township
Blair, NE 68008
402 426 5563
Owner:
Address
Anne Samson
1749 South St
Permit Fee:
Issue Fee:
Deposit Amt.
Receipt #:
25
25
Location
749 South St
Issued
Completed
5/20/2009
5/21/2009
Type: Mechanical Miscellaneous
Valuation
Permit
#: M
869
Blair Building Permit
Deta
r ' ) BUILDING INSPECTION REPORT
;'~F BLAIR
0 WASHINGTON COUNTY o OTHER
/ ?L/ q (itJuM cJf.
LOCATION OF INSPECTION:
NAME OF OWNER' A/}Vn! ~J cun<J trr7 .) h . I
CONTRACTOR' Ii ,M 'v01a-ftJ? (OWJ1
DATE INSPECTION REQUESTED' ..J{ - ;;< I - 0 't TIME INSPECTION REQUES;ED' I J..3c! fJ. f.1. PERMIT NO:
TYPE OF INSPECTION REQUESTED: o CONFERENCE o STATUS CHECK
BUILDING: o FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL .gs-FrNAL 0 PARTIAL P~~ED
COMMENTS:
UTILITIES: o SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE PASSED FAILED
o PARTIAL 0 0
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT PASSED FAILED
o PARTIAL 0 0
COMMENTS:
" ' ,~"".""., y ylS ~
MECHANICAL:D ROUGH-I~8I AlC 0 FURNACE 0 RADIANT HEAT ~::"FINAL 0 PARTIAL D~ul li-i/l PASSED AILED
t.f 1/' aG;#~ 0
COMMENTS: Yon A t!.- u11i;f /J1a)ll~_.. F~s:l'cr2tf'Cv;~A.~ I/cl
PLUMBING: o GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL PASSED FAILED
o PRESSURE TEST 0 0
COMMENTS:
- -
o OCCUPANCY GRANTED o CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS~ -
-
-
- -
-
-
-
-
INSPECTOR.1WitRJt DATE OF INSPECTION MADE: C5- ~ W b J
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
-~~
comment~
WHEN PROPERLY V ALIDA TED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: 0? J ~
Rev. 2008-
o
Current
License on File
~es
I
o No
$25.00
Total
,,- () Of
o N/A
~
Qt).
(}o
00
Signattm'
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.
Permit Issuance Fee
Radiant Heat Systems/Gas/Water
Piping System
Modular
Gas/Air Outlets.
Home.
.Additional
First 5
-
$50.00
.$50.00
x $1.00
x $6.00
Duct System
$15.00
Boiler Chart
BTU
Up to 100,000......
100,000-500,000..... .
500,000-1,000,000.. .
1,000,000-1,750,000. .
Over 1,750,000...
Completion Date
# of Units
Furnace
Central
Pump
AlC
Tons
Tons
BTU/H
AlC
Furnace
Fee
...$15.00
...$30.00
...$40.00
.. .$60.00
..$100.00
Appliance Vent/Fans
$10.00
Boiler (use BTU Chart to left)
Refrigeration Units/Coolers/Lines/Compressor - Commercial
(New or Replacement) (Per Unit)
$15.00
FurnaceIHeat Pump/Air Conditioner (Per Unit)
Over 100,000 BTU / 3 Ton.
d5. tXJ
.... ....$25.00
FurnaceIHeat Pump/Air Conditioner (Per
Up to and including 100,000 BTU /3Ton.
Unit)
.$
5.00
Heat
MECHANICAL PERMIT FEES
o Alteration
Zip
Zip
o Repair
eplacement
Application Date
.BC!..
Job Address
89 ()o 'I6'(){j7 9
t/ A-e <Sf. .EI ,e,
~,Lf q So
Phone
i 21/; - S$tp
Phone
Permit Fee
/3 Pt!,2
~
$
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
~
M
00
1869
~FBLAIR
LOCATION OF INSPECTION-
BUILDING INSPECTION REPORT
D WASHINGTON COUNTY
D OTHER
/ ? II '7 (,S t){j iA (cSt/
,,(Lr'~1'1 ',0 /'
NAME OF OWNER' /' I" ./ jjf(/
(, ~\/,;?"??t{) d''t'}
;".../ '/""1. Ai J!'.l,,'~1/) .,"("'j. -.'.' ,I"" }/.,..i(":_..'//,'I-',.,~ :yi(~/:",~., ..I!.,'/~'/~'~"(.<'"?,,,),
CONTRACTOR' [,1./ t>'''~, l iV',," ;'/.-;',;1-" 1/ /; (/".' /" L.."
. I" V
/A ::2, /4/111.11 : /i , /)1 r>
TIME INSPECTION REQUESTED' It/'I ,,/1.) r: bC'j, PERMIT NO' (".} f "',,1.7 ,"''{
f' '." , , j' I, 1./ "v 1
DATE INSPECTION REQUESTED' )':)",. ;::;; I (:J (l
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL [d}(FINAL D PARTIAL
D STATUS CHECK
P~~ED
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
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR'1i'~ fd~~
DATE OF INSPECTION MADE: C5- ;;l..)- 6W0Cl
TIMF- /(): I ()
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON
BY