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BP13318 E 0 8 Blair Building Permit Detail Permit #: 13318 Issued: 10/1/2009 Completed: 12/4/2009 Location: 1240 South St Owner: Brooke & Sam Slaughter Address: 1240 South St Blair, NE 68008 Phone: Section: Subdivision: Township: Range: Lot: 9 Type: Roofing permits - All types Valuation: 4800 Tear down to decking and replace with asphalt shingles and ice guard. Contractors McKinnis Roofing & Sheet Metal General Contractor Remarks Inspections Date 12/4/2009 By HOW Roof, Drains Permit Fee: Issue Fee: Deposit Amt.: Receipt #: Block: 72 Permit # Pass 40 25 50 25380 Issued (QJ) ( )Yaa q/J 6.$4- - d\') CITY OF BLAIR - Ml~9ELLANEOUS BUILDIN-G PERMIT i',::,!l:/"" ' , P 't# i,j~ I II J }(lil(1: erml' q 30l 0 OJ lOf311'Tr'A Date: ' , Approximate Completion Date: '-' I Site Plan Attached: Estimated Valuation of Project: 4 ?reo, 0i) 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.) Additional Description of project If necessary: 1ea- V- ~ \\\ &Q.,!q ns - ~ Y'e'f\a r L O!bfM 2~.SJ\1hojj s ~ ILL C-.ltJ. A.-(\(~L () PROJECT INFORMATION: Job Address: J 2.40 .svLtMf\ ~f- ct:]9Pc) t/b~70 V/,L /::..CJ~F 3318 Legal Description (if applicable) __3 (! ~ t- '7' ~'.Pi: 11 ///1& JI f. 3/,6 7',,;2 / /;< Pc f owner:B(O~-L*S(ltYJSI~~tress: ~ Phone#: Contractor: yy\ L. LlVl V\ l S. ~ IX]. '0 Phone #: Address: Cell #: From:MCKINNIS ROOFING & SHEET METAL 402 426 2344 10/05/2009 09:42 #957 P.001/003 2. 200910:43AM CITY OF BLAIR (402,426,4191) No.2525 p, 2 CITY OF BLAIR - MISCELLANEOUS BUILDING PERMIT r:2/t'J. ~ . I.D permlt# IS:;.! U Oate:Cf l3DtoOj Approximate Completion Date: }3 t> 1dl Site Plan Attached:_ Estimated Valuation of Ptuject: 4 ~&5.cD AppliCt,1tion for: Permit Fee $40 + Jssuanoe Pee $25 + $50 Deposit Fee: $115.00 Egress Window (floor plan drawing required) Fenoes (plot plan required) Gazebos (plot plan required) Patlos/Dr[veways/Sidewall<s (new or replacement) Roofing/SidIng/Soffit and/or Eave Repair/Gutters Swimming Pools with Fence (plot plan required) Window/Door Replacement ($lze ohangfJ onlY) MIscellaneous Building Permits (Items not covered bY OJle Qfthe above) Description: ~ Utility Excavation and Curb Grindlhg Curb GrInd Length Utility Excavation Length Type~ WateY~ Fe&: $75 plus bond .t~ .L1n. Ft.; Wldth_. " Lln. Ft : Sewer : Other Amount of Bond Posted~ Bond Checl< 4; (Curb grInd" $9,00 per Un. Ft.; UtilIty Exoavation . $6.00 per Sq. Ft,) Addltlon~1 Descrlptlon of project If t16Cessary: -rcttr .~ .~ d.v:dG[ fIt& - ~ Y'e~\n Cor.." Q<bf\'\lJ ~~ .Si-dhPfJ S 't' I (jL, ~tIL) 11leL . PROJf;CT INfORMATION: Job Address~ J 240~_ ~uJb Sf: Legal Description (If applicable) " o~,~er:B(O~+S(th1~I~~ress: '~ Conlrector. 'lYV-'... \6kt1'l1 S ~ ltl ';j Address: Phone#: Phone #: Cell it: . .' ..~. '. ~... . .. ,~... 1,0. I. I. ". ~.., . . ..l....."...,... From:MCKINNIS ROOFING & SHEET METAL 402 426 2344 10/05/2009 09:42 #957 P.002/003 Oct, 2. 2009 10:43AM CI TY OF BLAIR (402.426,4191) No. 2525 P. 3 PERMIT RENEWA~ EEE: This fee Is based on the amount of the original permit fee and Is charged when work is not oompleted within two years and the permit expIres. Renewals wifl ~ be Ell/owed with the stipulation that all exterior site work and outside finish work Is completed and interior life- safety Issues have been properly address. Permit renewals ~~ for one (1) year, with a maximum of two (2) renewals for a maximum permit span oHour (4) years. Original valuation of $0-$50,000 $150.00 $ Original valuation of $50,000 - $100,000 $200.00 $ Original valuation of $100tOOO - $500,000 $300.00 $ Original valuation of $500,000 or more $400.00 $ !S$uance Fee: $ 25.00 $ 50.00 Deposlt~ Total Renewal Remit Fee ... Permit Fee + Deposit + Issuance Fee $ 'Il, '. .......... ..,,..........~...,,,..,...........,,........o-. ... 'I' ....,..~.... .~.~, ~.,l'", .....t.~......'IH.~.'....,"""'......,..................,,.~....". '.' Separate permits are reqult'et! for electrloal, plumbing, hearUng, ventilating and aIr conditioning, and septic $ystems. By my slgnatura balow, I aQKnowledgs thIs buildIng permIt application (toes not (':of\&tltule Issuanoe of this building !)i)rrrlit. I further agree th\!lt CQtllitruation oovered by thIs permit applloatlon shall not be commenced Uhtlll haVll received a copy of a pel'lnlt slgn~ by the t3uildlng Inspector. I hereby agree to petform th~ proposed work In accordance with the speelflcaUon$ set forth above and In Mcordance with the eo'Il~s1ordlr\an(;$$ of the cny of Blair and the Stata of Nebraska. I understand that thIs parmtt 1$ void if work Is not commeneecfwlthin 180 days or Is not completed within two {2} yeara of data of issue. ;01 /0" 0- - ""~ ~ For Offf~e Use Only WH5N PROPERLY VALlOATEQ (BELOW) THIS IS YOUR PERMIT DatepermltPald:I!~/"'tJ7 Rec$lpt# ,fl55t10Approved'by: 2 P~/;,fJ~ 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 only be allowed with the stipulation that all exterior site work and outside finish work is completed and interior life- 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. n ~ #IJ~tIU?/ For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT /1/..-/)//}.Kf,QO . S:> cp I:. Date Permit Paid: . t/" V Receipt # ~ J_? Approved by: c25~' ../, 'J~--.J ~t's;d ~ 0;6f~uOJ ~~rJ / /;J (jY / ,5'1"- cYl ,,~''''1 /(/ C" ott-foC8 From:MCKINNIS ROOFING & SHEET METAL 402 426 2344 10/05/2009 09:42 #957 P.003/003 Oct. 2. 200910:44AM CITY OF BLAIR (402,426,41911 No, 2525 p, 4 BUILDING PERMiT PEPOSIT AGREEMENT A $500.00 refundable deposit. Is being collected for any new oommercial, new residential, and anyadditionsl remodels and accessoty building valued $10,000 or greater at the time of your building permit appllcatlon- A $200.00 refundable deposit Is being collected for any residential remodel, a mo ,_ r accessory building valued under $10,000, e City reserves the right to not refund this deposit If any of the following conditions occur during the construction period: 1) ThE?ft of water selVice by the plumber, owner or general oontractor. 2) AU permits have not been obtained. 3) All required Inspections have not been obtained. 4) Occupancy occurs prior to a final inspection, 5) The prOject is completed without a final inspection being done. 6) Storm Water Management Plan inspection not obtained, (If Required) If any or all of these situations occur during construction) you may fol1eit your deposl . I hereby agree to the above oonditions, and understand that should any or all of the above situations occur, the building permit deposit SHALL be forfeited or discounted upon the discretion of the City of Blair) Building and Inspections Department. @c~ r..... ?7J~~tlS ~tG6 Contractor/OWner City of Blair ~le CITY OF BLAIR, NEBRASKA Phone 402-426-4191 RECEIVED OF: ~ ' I '-/JJt ;(JtWWJ/ & ADDRESS /'dt L/ j". /~,? .' 4E utl'otJ8 CITY, STATE. ZIP CODE g/ae4 ~3H!~tI1 0'00000 0001. 1,....1 00 ~~42024 1 '.'" 1 () CHf"H~~GEl :$:l:t ~5 ~~ oYf ~~J . 1Yfb J' THANK YOU NO 2 5 3 8 0 Pounds Printing, BIaiJ:. NE 68008 ?IN 'C:::h"dry OF BLAIR BUILDING INSPECTION REPORT D WASHINGTON COUNTY D OTHER LOCATION OF INSPECTION' NAME OF OWNER.l?{';~)',(;>il~) :/ j' l~':>\, '\ ~ r1--. ''<'..f~. (/ ., , :5 0 0+ H ::;~, (,\~t''1i1 (,L~1;tll(Ji~lA?4, CONTRACTOR' >:Y;~YA2::/iLlll{1 Il" DATE INSPECTION REQUESTED'" /,~;;l!. . Ii,]!" . t:) ~l TIME INSPECTION REQUESTED'/} 7" PERMIT NO' I~:,~:} /') " I ,,---,'''' TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D 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 D REMOTE D WATER SERVICE D PARTIAL \ASSED FAILED ~l D .f -_,'~, 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 DD COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D PASSED FAILED D D CUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' INSPECTOR' ',. i,<", ",J 7)'~ .~~" ?~", , DATE OF INSPECTION MADE: J .:-~1 -If '~,_ " "~, e:'J -/ TIMF' .r i.J .' ;",./\ :"i'~/' ~ ;", ./ FAXED OPPD\BURTREA TO CONNECT SERVICE: ON BY