BPM1955Permit #: M1955 Issued:
2/17/2010 Type:
Mechanical Miscellaneous
Completed:
2/18/2010 Valuation:
Location: 2366 Park St
Owner: Helen & Clarence Sheets
Permit Fee: 15
Address: 2366 Park St
Issue Fee: 25
Deposit Amt.:
Blair, NE 68008
Receipt M
Phone: 402 426 -3259
Section: Township:
Range:
Subdivision:
Lot:
Block:
80,000 BTU furnace replacement.
Contractors
Washington County Heating & A/C
Inc. General Contractor
Permit # Issued
Remarks
Inspections Date By
2/8/2010 HOW Final Inspection of Project Pass
2/18/2010 HOW Mechanical Final Pass
r/17 BUILDING INSPECTION REPORT
TYPE OF INSPECTION REQUESTED _ _ ❑ CONFERENCE
W ❑
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑v FINAL PARTIAL
J v PASSED
FAILED
COMMENTS:
-
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ ❑ WATER SERVICE
` 'U PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑. FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL r _
V PASSED
FAILED
❑
C OMMENTS:
LJL`
PLUMBING:
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
C OMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
INSPECTO • DATE OF INSPECTION MADE: °-1 - 1 (3 T IME• / 0
FAXED OPPD \BURT REA
TO CONNECT SERVICE:
BY
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16 th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1955
(402) 426-4191
Application Date: - c Permit Fee: $
Job Address
Own
1. �y ` IM Zip Phone
Contractor A Mail Address Zip Phone
2.
3. Class of Work: r] Cg(AMERCIAL 13 RESIDENTIAL
C3 New C3 Addition 13 Alteration 13 Repair 0 Replacement
Describe Work:
4. rZ-
MECHANICAL 4 FEES
Heat Pump Tons
Central A/C Tons
Fumace/Heat Pump/Air Conditioner (Per Unit)
Furnace BTU/H
Up to and including 100,000 BTU / 3Ton ... .........................
of Units A/C
Fumace/Heat Pump/Air Conditioner (Per Unit)
Furnace
Over 100,000 BTU / 3 Ton ......... .......... .........................$25.00
Completion Date:
Refrigeration Units/Coolers/Lines/Compressor — Commercial
(New or Replacement) (Per Unit)
.............................................................................. $15.00
Boiler Chart
BTU Fee
Up to 100,000 ....... .........................
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
Boiler (use BTU Chart to left) ....................
Appliance Vent/Fans ........................$10.00
Notice
1 hereby certify that I have read and examined this
Duct System ......... .........................
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type o f
Gas/Air Outlets ................. 5 x $6.00
work will be complied with whether specified herein or
not. The granting of a permit does not presume to give
......... Additional X $ 1.00
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
Radiant Heat Systems/Gas/Water
Piping System ....... .........................
Modular Home ............................... $50.00
- t A "'i
Signature of Contractor or Authorized Agent
Im
Permit Issuance Fee . .........................$25.00
Total
Current License on File Xyes 0 No 13 N/A
a t e
Comment' ,
60 "t"f Y
L"M"4 1,
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS LYOUR PERMIT
Approved By:
Z)
Rev. 2008-10
INSPECTORd DATE OF INSPECTION MADE: P - 19 7 10 TIME 1130
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON
BUILDING INSPECTIO N REPORT
CITY OF BLAIR
❑ WASHINGTON COUNTY ❑ OTHE
LOCATION OF INSPECTION -
NAME OF OWNER
C, ° CONTRACTOR - J
DATE INSPECTION REQUESTED — L-L 2 TIME INSPECTION REQUESTED PERMIT NO
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING F] DECK FOOTING ❑ FRAMING [:1 DRYWALL ❑ 'FINAL [:1 PARTIAL
J PASSED
FAILED
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE F WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE F PRECONNECT
PASSED
FAILED
F
PARTIAL
COMMENTS:
MECHANICAL: Fl
ROUGH-IN ❑ A/C, RADIANT HEAT —1 ❑F FINAL El PARTIAL
PASSED
FAILED
El
COMMENTS:
PLUMBING: F
GROUNDWORK ❑ ROUGH-IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
F
PRESSURE TEST
F
❑
COMMENTS:
F OCCUPANCY GRANTED
❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS
INSPECTORd DATE OF INSPECTION MADE: P - 19 7 10 TIME 1130
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON