BP12408
CITY OF BLAIR - MISCELLANEOUS BUILDING PERMIT
Permit # /;lL/o8
I-I / j I I
Date: !Ji Zei !(Y'1 Approximate Completion Date:U II DO) Site Plan Attached: r !}(D;{
Estimated Valuation of Project: I ()(;('H)()
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: Or U I/,'rd{
(' . ':;j r.J r h ') ,j)(t~ (/>1\/ Jf (jjlrnf\(
. .. r /
!~N
l. (, ',,__-
!
['CLryT)
PROJECT INFORMATION:
Job Address:
, I G (j r. Ii r
I \ ~ . . ,-I
! /! eJOU' l\ -.,r,
Legal Description (if applicable)
Owner:
'I.'} f'. HI
~1P fI,k(\ ( /1\(1. ,n.rr /.--
I I "--l- '. ,\ {r (_~' '.A...-; .
Address:
Ul '/n. -/ ')
Phone#: 1';:1 T('i ,~
Contractor:
",' j (~\
(..:.... r.) L-;"'-
.0 ".l I
Phone #:
Address:
" I) (' -- il'. (~L
II ( '; '-./ . ). I:! '." i' \ "'1',
Y ( '._ \.i\/\ i '.,~
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 $ J 50, O()
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.
Signature of Owner/Contractor
Date
For Office Use Only
Date Permit Paid:
WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Receipt # ZlI70() Approved by:~=f;;[_i~;t/;JIi;Jt~=~
"'~
'"
" (l'...
. a! ".
. . -1 Promise 0\
CITY OF BLAIR - MISCELLANEOUS BUILDING PERMIT
Permit # /;;? L/ () 8
tf~1 ~()8 Approximate Completion Date: 'fj q ~3o -01ite Plan Attached:
Estimated Valuation of Project: /tJOO. oC')
Date:
Application for:
Permit Fee $20jlssuance Fee $20
Fee: $40.00
Sign Erecting, Awnings (Per Sign)
Roofing/Siding/Soffit and/or Eave Repair/Gutters
Window/Door Replacement (Size Change Only)
Egress Window (floor plan drawing required)
Swimming Pools with Fence (plot plan required)
Fences (plot plan required)
Decks/Handicap Ramps (plot plan required)
Satellite Dishes/Radio Antenna/Cell Towers (plot plan required)
Gazebos (plot plan required)
Miscella~eous Building Prrrr:'its (items not qovered!?i: one of the ab5>ve)
Other PddJdP1~lld ~ode/ ~ ~/l <1?tJa/
,
v
Patios/Driveway Permits/Utility Excavation and Curb Grinding Fee $35
Curb Grind
Length
Utility Excavation
Length Un. Ft.; Width
Type: Water ; Sewer ; Other
Un. Ft
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Un. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
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 permit fee of $0-$50,000 $100.00 $ /0 () . 00
Original permit fee of $50,000 - $100,000 $150.00 $
Original permit fee of $100,000 - $500,000 $250.00 $
Original permit fee of $500,000 or more $400.00 $
Issuance Fee:
$ 20.00
$ /;?tJ tJu
Total Renewal Remit Fee = Permit Fee/Issuance Fee
(
Additional Description of project if necessary: \...
oU A. CV11 -'
PROJECT INFORMATION:
Job Address:
//i/ r Jot/Ii I (I/-.
-
JY~;p~ cl1v;/J Phone#: '121/-;797;;;
Address:
Phone #:
Cell #:
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. .
4~~~
Signature of Owner/Contractor
),1-7.-08
Date
For Office Use Only
WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit Paid: ~ -7 -tlt)
Receipt #
31
?p / Approved by:
g. ~/f~
,~{ CITY OF BLAIR
BuiiD iNG INSPECTION' REPoiiT~~~~,~e~-~-?o.~~
o WASHINGTON COUNTY
LOCATION OF INSPECTION' 1// &; 9 :~~/.L7;~/ _.e::::;-~
I /,r71 / /J:.t? ;""7-
NAME OF OWNER- .~/("EII //( cZ;z /& .e;./
DATE INSPECTION REQUESTED' / /IJ,& /1:J 9 TIME INSPECTION REQUESTED'
f (
o OTHER
CONTRACTOR'
;Yjf1
TxPE OF INSP~CTION REQUESTED:
BUILDING: D FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL
/6/L.f\u
PERMIT NO' /.:::/) Y{/G/
o CONFERENCE ~ATUS,' ~JiECK
~----- ~~ .~
o FINAL 0 PARTIAL PASSED FAILED
o 0
UTILITIES: D SEWER TAP. 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
~LECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
PASSED fAILED
o 0
,l\mCHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
P AS~SED FAILED
[J 0
COMMENTS:.. .
~~~~~~~~~~.....~-=
~""'~~~~"~~.....,,...,.:~
PLUMBiNG:..'[l.G~QUNDWO~ 0 ROUGH~IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
. .'. '..',' :'~;,'D"pREss'uim:TEST
COMMENTS'" ~c' ,
6"~dc~~~x"i~.~i?; _D:;20NtiITidNALOCC~ANCY GRANTED
· PASSl:}p< FAILED
m:" D
-L:.::..J' .
.. . '. ~ ,
~~~~~~
::; I
:,-
~ : "
; N9tESiRE~~g,.,^~~' ,
,::-.'
. '"',~ -'- .' >
- '..,.
".,--;'
, '-~:i'- '., .
- .-: '.'; ;',~::' ...'-;.' ,
..,... ,
P'" .
.~I
~~'U' .
IJ I -l" '
,II
,
BUILDING INSPECTION REPORT
~1TY OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION' / / ~ '1 S6k7-1f
NAME OF OWNER' ,/,11/77/ {fbL?tk;:;--- CONTRACTOR'
DATE INSPECTION REQUESTED- __1' h16 /OS?TIME INSPECTION REQUESTED'
I I
AT
PERMIT NO' /~ 4-u8
/
o STATUS CHECK
"
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
PASSED FAILED
D D
COM:MENTS:
\
UTILITIES: D SEWER TAP J~ SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIA.r"
PASSED FAILED
D D
COM:MENTS:
17 I:. --;Ullil'l7L I1Illlilmll:
'\' ,
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COM:MENTS: .
MECHANICAL:D ROUGH-IN D A/C D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COM:MENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED 0 PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
~~"''''''....
_...~!E:lI!lIllll:i:':m:m:lZiLL
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
DATE OF INSPECTION MADE:
TIMF' /. ~ 1/-/
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
.
-
.
-
-
II'.
-'
-
.--
--
~
-- ....... \
-
BUILDING INSPECTION REPORT
DATE OF INSPECTION MADE:
17
,,CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHE
FAXED OPPD\BURT REA
LOCATION OF INSPECTION
B
NAME OF OWNER: CONTRACTOR L
DATE INSPECTION REQUESTED-,, TIME INSPECTION REQUESTED (Z f PERMIT
No
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL El PARTIAL
PASSED
FAILED
1:1
Nl—
COMMENTS:
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑ PARTIAL
❑
F-I
COMMENTS:
ELECTRICAL: F ROUGH IN ❑ FINALE] PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
El PARTIAL
❑
❑
COMMENTS:
MECHANICAL: Fl ROUGH-IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL PARTIAL
PASSED
FAILED
F
F1
COMMENTS:
PLUMBING: ❑ GROUNDWORK E] ROUGH-IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
F] PRESSURE TEST
El
F]
COMMENTS:
F OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS7 I'A
INSPECTORL"/�I.a...
DATE OF INSPECTION MADE:
17
- 6 A
TIME--t —
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
B