BP13317
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Blair Building Permit Detail
Permit#: 13317 Issued: 9/28/2009
Completed: 10/21/2009
Location: 1025 State St
Owner: Theodore & Sheri Jensen
Address: 1025 State St
Blair, NE 68008
Phone: 4264703
Section:
Subdivision:
Replacing Roof and Gutters Asphalt Shingles.
Township:
Range:
Lot: 2 3 4
Contractors
Frank Gabby Siding & Windows
2 3
Type: Roofing permits - All types
Valuation: 13400
General Contractor
Remarks
Inspections Date
10/21/2009
By
HOW
Final Inspection of Project
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
Block:
Permit #
Pass
40
25
50
25337
Issued
CITY OF BLAIR - MIS:~'~'OL@rQ;abUls(B0llil:SlING PERMIT
Permit # I 331 7
Date: 9 -,J tJ.,oq Approximate Completion Date: 10-:3/-01 Site Plan Attached:
Estimated Valuation of Project: j 3 I 4- 00. ()()
Application for: Permit Fee $40 + Issuance Fee $25 + $50 Deposit
Fee: $115.00
Egress Window (floor plan drawing required)
Fences (plot plan required)
Gazebos (plot plan required)
Patios/Driveways/Sidewalks (new or replacement)
Roofing/Siding/Soffit and/or Eave Repair/Gutters ~
Swimming Pools with Fence (plot plan required)
Window/Door Replacement (size change only)
Miscellaneous Building Permits (items not covered by one of the above)
Description:
Utility Excavation and Curb Grinding
Curb Grind
Length
Utility Excavation
Length
Type: Water
Fee: $75 plus bond
Un, Ft.; Width
; Sewer
Un. Ft
; Other
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Un. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
'tional Description of project if necessary: . J(?a{~1:' JP ~czf t::bH c/
t~ ., a I- " I. i?
PROJECT INFORMATION:
Job Address: /tJ,;<6- Jfc:>..b !}f 8</'00 c;?/,8;;l..:5--'
Legal Description (if applicable) $c!- ;;<013,0;761 70-1;;; Cot) I~f-C; 3/L.2
Owner: ~tlaI~V~'(J~~' c/J""~dress: /o25J Jll-c?.bcf~ Phone#: L/.;l6-.1!f7a3
Contractor: ~1??cI!e ;~~,{<'/~ Phone #: L/2/P - 3/3;;;
Address:
;Pc.
Cell #:
PERMIT RENEWAL FEE:
This fee is based on the amount of the original permit fee and is charged when work is not
completed within two years and the permit expires. Renewals will onlv be allowed with the
stipulation that all exterior site work and outside finish work is completed and interior Iife-
safety issues have been properly address. Permit renewals are for one (1) year, with a
maximum of two (2) renewals for a maximum permit span of four (4) years.
Original valuation of $0-$50,000 $150.00 $
Original valuation of $50,000 - $100,000 $200.00 $
Original valuation of $100,000 - $500,000 $300.00 $
Original valuation of $500,000 or more $400.00 $
Issuance Fee:
$
25.00
Deposit:
$
50.00
Total Renewal Remit Fee = Permit Fee + Deposit + Issuance Fee $
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 completed within two (2) years of date of issue.
cy.- ;;<. g - c::?;r
Date
For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit Paid: tj-;;j'.-tJ1 Receipt # .;25;37 Approved by: ,11 j/j IJ'f...cLt--..-~
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 or BLNQ
ROOF PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and/or roofing permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2006 International Buildina
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing 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.
Owner/Occupant
~~~
. Contractor tJ
City of Blair
Q 9' .- ;Z 13- o?
ate
(5)-
EQUALIlOUSl'lQ
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cilyofblair@cLblalr,ne,us "'''''''''
~t/ PLCtF'<_
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BUILDING INSPECTION REPORT
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LOCATION OF INSPECTIO~;
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NAME OF OWNER' l t/'t.!/ill(.f?'rf!A'/ C
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CONTRACTOR'
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TIME INSPECTION REQUESTED'
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PERMIT
DATE INSPECTION REQUESTED' //~;:/i
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TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL,;ti3,;'j~;iNAL D PARTIAL
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
D STATUS CHECK
~ F~ED
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 AfC D FURNACE D RADlANTHEAT 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
PASSED FAILED
D D
NOTES/REMARKS'
INSPECTOR'
1f~+
DATE OF INSPECTION MADE:
It) -'J-(- (;) q
,
TIME' ;;..,.5 t~WfA../
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY