BPM1874
Permit#: M1874 Issued:
Completed:
Location: 640 N 23rd St
Owner: Amy Johnson
Address: 640 N 23rd St
Blair, NE 68008
Phone:
Section:
Subdivision:
1.5 ton Airconditioner Replacement
Township:
"if
Blair Building Permit Detail
6/3/2009
6/5/2009
Type: Mechanical Miscellaneous
Valuation:
Range:
Lot: 5 & 6
Contractors
Washington County Heating & AlC Inc. General Contractor
Remarks
Inspections Date
6/5/2009
6/5/2009
By
KAR
KAR
Mechanical Final
Final Inspection of Project
Permit Fee: 15
Issue Fee: 25
Deposit Amt.:
Receipt #:
Block:
Permit #
Issued
Pass
Pass
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BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
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NAME OF OWNER-
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
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TIME INSPECTION REQUESTED'
DATE INSPECTION REQUESTED'/ <-
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:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
MECHANICAL)Q ROUGH-IN'~ AlC 0 FURNACE 0 RADIANTHEATQ(~f1NAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
PASSED FAILED
o 0
~F~ED
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
o 0
NOTES/REMARKS'
DATE OF INSPECTION MADE: ~ ~ -0 5-- ~ TIME' J.' '2 {C;:-
INSPECTO .
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
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MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1874
(402) 426-4191
Application Date:
u-3-tJ7
Job Address
Heat Pump Tons
Central AlC /"c5 Tons
Furnace BTU/H
# of Units AlC
Furnace
Completion Date:
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 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.
Signature of
~r~
Date '
J/A,ClO
.c;:' / ,.ferm. it Fee: $ '::LtL
6 1 tia -J V71f!;@
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Zip Phone
'AiD. NSel'S / 70 I Lc;fs 6'(' e,.6
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'(;,(4 lP
o Alteration 0 Repair
Replacement
MECHANICAL PERMIT FEES
Furnace/Heat Pump/Air Conditioner (Per Unit) /5 00
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 Outlets.................First 5
x $6.00
. . . . . . .. .Additional
x $1.00
Radiant Heat Systems/Gas/Water
'ping System... ...... ... ...... ... ... .. ..... .$50.00
Modular Home... ... ... ... ... ... ... ... ... .... $50.00
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Permit Issuance Fee... ... ... ... ... ... ........ $25.00
Total
Comment: ~
Current License on File
o No 0 NjA
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: 3 1,-" I~
I
Rev. 2008-10
BUILDING INSPECTION REPORT
ElA;:rTY OF BLAIR
/
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
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DATE INSPECTION REQUESTED''! (,.
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I TIME INSPECTION REQUESTED'
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NAME OF OWNER'
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
PASSED FAILED
o 0
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
COMMENTS:
MECHANICAL)Q ROUGH-IN'~ AlC 0 FURNACE 0 RADIANTHEAT JS1:&AL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
~FAILED
~. 0
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
DATE OF INSPECTION MADE:
()~ -OS-d/.tJ9 TIMF' }.' 2<~
INSPECTO .
FAXED OPPD\BURTREA
TO CONNECT SERVICE: ON
BY