BP12618F BLAIR - MISCELLANEOU,5. BUI wr
t
Permit`#L'/g
A Promise o
Date: J �- I Approximate Completion Date: Site Plan Attached:
Estimated Valuation of Project:. -3 b) Z./ �' o
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
Fee: $75 plus bond
Length
Utility Excavation
Length Lin. Ft.; Width Lin. Ft
Type: Water ; Sewer ; Other
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Lin. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
Additional Description of project if necessary:
PROJECT INFORMATION:
Job Address:
0
Legal Description (if applicable)�� a �4101%
Owner: Address: 1r�/v�� Phone#:In Z
Contractor: IAa- 7yez& Phone #:
Address: Id 5
1,7
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 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 $ 34®,
Original valuation of $500,000 or more $400.00 $
Issuance Fee: $ 25.00
Deposit: $ 50.00
0
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.
/ZV4
SignatureOwner/Contractor Date
For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit Paid J Receipt # Approved by: _� ;
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
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Application Date:
PLUMBING PERMIT APPLICATION�
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
-7blI(0
Permit Fee: $ ,
Job Address c -L D
O�vn r t }f-��-{Mail�lddress
mak
/t'or `� `
Zip
Phone
Co ra Mail Address
2.
Zip
Phone
3. Class of ork: O COMMERCIAL RESIDENTIAL I
XNew 0 Addition O Alteration O Repair 0 Replacement
Describe Work:
4. 1 V1 ( n
AA
PLUMBING PERMIT
FEES
Comments:
Modular Home ......................$50.00
Type of Fixture No.
Kitchen .............................. $12.00 x
i ' 2, (YO
Bath.....Residential/Single Stall $12.00 x
....................Multi -Stall $25.00 x
Rough -In Bath ........................$8.00 x
Do
Additional Sinks .....................$6.00 x
Slop Sink/Laundry Tray/Drain ..... $6.00 x
Water Heater .........................$10.00 x
^^\\
D' nV
Notice
Outside Water Faucet...................$6.00 x
Z % `Z ,Oct
I hereby certify that I have read and examined this
Drinking Fountain ........................$6.00 x
—"
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
Backflow/Grease Trap$15.00
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
Water Service .......................$15.00
state or local law regulating construction or the
Sewer
performance of construction.
.................................$15.00
Groundwork .........................$15.00
.�
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System ............ $10.00
Sprinkler System (Commercial)..$30.00
Gas/Water Piping System
(Commercial) ........................ $50.00
gnature of Contractor o uthorize Agent
Permit Issuance Fee.................$25.00cy
Total
_
Current License on File 0 Yes CfNo
0 N/A
Date
Comment:
WHEN PROPERLY VALIDATED (INTHIS SPACE) '1HIS 1S YUUKPEKMll
Approved By:
Rev. 2008-10
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: I � 11 t 0
b
M 2013
Permit Fee: $
Job Address
z
0' r Mail dr s
Zip
Phone
1.AWA .
C actor Mail Address
Zip
Phone
2
3. Class ofWork: O COMMERCIAL RESIDENTIAL
O New O Addition O Alteration O Repair
O Replacement
Describe Work:
4. me1 ( a}/`
MECHANICAL PERMIT FEES
Heat Pump Tons
Central A/C Tons
Furnace/Heat Pump/Air Conditioner (Per Unit)
150-00
Furnace ()0 BTU/H
Up to and including 100,000 BTU / 3Ton............................$15.00
# of Units A/C
Furnace/Heat Pump/Air Conditioner (Per Unit)
Furnace
Over 100,000 BTU / 3 Ton.............................................$25.00
Completion Date:
Refrigeration Units/Coolers/Lines/Compressor —
(New or Replacement) (Per Unit)
Commercial
Boiler Chart
BTUFee
.........................................................................$15.00
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
..
Boiler (use BTU Chart to left).............. ....
e
Applianc Ven ans.:: O-� kl't?9?-�...$10.00
I
Notice
1;100
I hereby certify that I have read and examined this
Duct System..................................$15.00
application and know the same to be true and correct. All
Gas/Air Outlets5 x $6.00
provisions of laws and ordinances governing this type of
.................First
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
Radiant Heat Systems/Gas/Water
----
performance of construction.
Piping System................................$50.00
Modular Home ............................... $50.00
--
31 Q 90(VtA W\11A6CfVA-,
Signahr - f Contr t r or Authorized Agent
Permit Issuance Fee .......................... $25.00
'(0
Total <60
t V
y
Current License on File ,�7 Yes O No O N/A
/
Date
Comment:
WHEN PROPERLY VALIDATED (1N '1'H1S SPACE) '1HIS 1S YUUK PEKMll
Approved By:
Rev. 2008-10
I
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1966
(402) 426-4191
Application Date: I F -/61 - /t/)
Permit Fee: $ Al)
Job Address
Ownerd Phone
P4
Contractor M4ai�dd essVzip Phone
2 A
3. Class of W&k: 173 COMMERCIAL-gLkESIDEN-IIAL a -Kew ti Addition 13 Alteration C3 Repair 0 Replacement
Describe Work:
4. A&I �� 6/l/ - '/�, 611-;�7C6-
MEt'ftANICAL PERMIT FEES
Heat Pump Tons
Central A/C Tons
Furnace/Heat Pump/Air Conditioner (Per Unit)x
Furnace /4 0®0
4000 BTU/H
Up to and including 100,000 BTU / 3Ton ............................$15.00
of Units A/C
Furnace/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)
Boiler Chart
BTUFee
.............................................................................. $15.00
Up to 100,000 ................................$15.00
100,000500,000 ..............................$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 /0.00
Notice
Duct System .......................... ......$15.00 1�6
1 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
Gas/Air Outlets .................First 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
Radiant Heat Systems/Gas/Water
performance of construction.
Piping System......... $50.00
C4 4
Modular Home ............................... $50.00
Signature of ContratT or AuthonizeaAgent
Permit Issuance Fee .......................... $25.00
Total �c�% 0 0
Current License on File es 13 No C3 N/A
Date
Comment:
WHEN PROPERLY VALIDATED (INTHIS SPACE)THIS IS YOUR PERMIT
Approved By:
Rev. 200810
-v _ �r
dco
m
1
PLUMBING E APPLICATIONP
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 P 2094
(402) 426-4191
Application Date: "0 Permit Fee: $ A
Job Address
/ t2l ) i
Owner ailLA mess
�/j (\ /Zip)
d�hon/� C
Contractor dress
2.r,
Zip
Phone
3. Class of Work: O COMMERCIAL -RESIDE IAL
'blew O Ad ition O Alteration O Repair
O Replacement
Describe Work:
4. 71_&x111 ' =
�/ � CNS
PLUMBING PERMIT FEES
Comments:
Modular Home ......................$50.00
Type of Fixture No.
Kitchen .............................. $12.00 x
Bath.....Residential/Single Stall $12.00 x
....................Multi -Stall $25.00 x
Rough -In Bath ........................$8.00 x d
��
Additional Sinks.....................$6.00 x
Slop Sink/Laundry Tray/Drain ..... $6.00 x
`
Water Heater .........................$10.00 x
Notice
Outside Water Faucet...................$6.00 x
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
Drinkin g Fountain ........................$6.00 x
%
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
Backflow/Grease Trap$15.00
authority to violate or cancel the provisions of any other
Water Service .......................$15.00
state or local law regulating construction or the
performance of construction.
Sewer.................................$15.00
Groundwork .........................$15.00 �_
J^ ° o
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System ............ $10.00
Sprinkler System (Commercial)..$30.00
Gas/Water Piping System
(Commercial)...... ............$50.00
Signature of Contr r or Authorized Agent
Permit Issuance Fee.................$25.00
�L
Total
Current License on File ji Yes O No O N/A
Date
Comment:
WHEN PROPERLY VALIDAYED (IN THIS �WAUE) THIN I�i Y U U K FEKIVlll
Approved By: /
Rev. 2008-10
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ENTERED JAN
PLUMBING PERMIT APPLICATION
Jurisdiction of City of tBlair, Nebraska �c %
218 South 16 Street
Blair, Nebraska 68008
Fax (402) 426-4195 P 2074
(402) 426-4191
y
Application Date: Z/
L 61
Permit Fee:
Job Address r qX — .
®
Owner Mail Address Zip Phone
1.
Contractor - it Address Zip Phone
2.
3. Class of Work: O COMMERCIAL SIDEN IAL I lacNew O Addition O Alteration O Repair O Replacement
Describe Work:
4. r° C='
PLUMBING PERMIT FEES
Modular Home ......................$50.00
Comments:
Type of Fixture No.
Kitchen .............................. $12.00 x
Bath..... Residential/Single Stall $12.00 x
..........I .........Multi -Stall $25.00 x
Rough -In Bath ........................$8.00 x
Additional Sinks.....................$6.00 x
Slop Sink/Laundry Tray/Drain ..... $6.00 x
Water Heater .........................$10.00 x
Notice
Outside Water Faucet...................$6.00 x
I hereby certify that I have read and examined this
Drinking Fountain ........................$6.00 x
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
Backflow/Grease Trap ............. $15.00
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
Water Service .......................$15.00
state or local law regulating construction or the
Sewer.................................$15.00 l
_.
performance of construction.
Groundwork ......................... $15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System ............ $10.00
i
Sprinkler System (Commercial)..$30.00
,�-,_s. -
Gas/Water Piping System
jr C ,> ff
�,._.
A�
(Commercial)........................$50.00
.Signature of Contractor orAuthorized Agent
Permit Issuance Fee.................$25.00
Total
File es O No O N/A
/
Current License on
Date
Comment:
WHEN PROPERLY VALIDATED
(IN THIS SPACE) THIS IS YOUR PERMIT
Approved By: '
RP..
IMR_1
J�
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:
T 1365
Permit Fee: $°
00
Job Address t �,
Owner Ivy Address. Zip Phone
Contractor Mail Addres Zip Phone
3. Class of Work: O COMMERCIAL ESIDENTI ew O Addition O Alteration O Repair O Replacement
Describe Work: f o
4. ; „44 /
PLUMBING PERMIT FEES
Comments:
Water Tap Fee — 3/4" $150.00
Water Tap Fee —1" $200.00
Water Tap Fee —1 1/211 $250.00
Notice
I hereby certify that Cead 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
Water Tap Fee — 2" $300.00
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
Y ormance of construction.
�� eA-11
Signature of Contractor or Authorized Agent
1✓
Total'
Current License on File es O No O N/A
/�)
Date
Comment:
WHEN PROPERLY VALIDATED (1N 1H1N NFACE) 1Hla IN YUURFhFM11
Approved By: % ;
, Y
Rev. 2008-10
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CITY OF BLAIR - MISCELLANEOUS BUILDING PERMIT
Date: Zd- 21 ' Approximate Completion Date: 1 0 q Site Plan Attached:
Estimated Valuation of Project: &LO1 Zi L � 0-
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)
Roof ing/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
Fee: $75 plus bond
Curb Grind
Length
Utility Excavation
Length Lin. Ft.; Width Lin. Ft
Type: Water :Sewer ; Other
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Lin. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
Fat; �11 $
Job Address:
Legal Description (if applicable) C,>
Owner: A'e x' Z'�Zj
Address: S, %W 4 30 Phone#:
Contractor: / 4 Phone #:
Address: i `� Cell #:
m
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�pom;saaa CITY OF BLAIR ® APPLICATION FOR BUILDING PERMIT
Permit # / :1l
Date;Z ® 1— Approximate Completion Date: ��
Site Plan Attached: REScheck Attached: Complete Plans Attached
Application for: Residential - Commercial/Industrial
New Construction - Manufactured Home Modular
Move -on: Home Accessory Building Other°
Remodel Addition
Accessory Building: Garage Pole Barn Other
Floor Type: Dirt Concrete Electricity: Yes No
Other
Utilities: Public Water: Yes . No Private Well
If yes, responsible entity: Blair < OPPD Line Kennard
Agreement needed: Date Agreement Received:
Public Sewer: Yes N- No Septic Drawing Provided:
If yes, responsible entity: Blair Kennard
Miscellaneous Permits: Electrical Plumbing Heating
County Road Permit Required: -,Yes . No Submitted: Yes No
Additional Description of project if necessary: �rG �'6'���% '
r � _t' /
d�� -r�� .may L �s
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�� ��! J ' PL,.Z f L. "i'..T &"` �� G.✓'T L'',�" i �ry ism. J "1 ,� cr`$ .,
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Project Information:L4 C
Job Address:
Legal Description (if applicable)
meg" /
9'
i
Owner:
Contractor.
Address: /i
® Address:hl,-
�a
C Phone#:
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 s or is not completed within two (2) years of date of issue.
.tel y
ignat re of Owner/Contractor Date
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 permit fee of $0-$50,000 $100.00 $
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: $ ,�"), 00
Deposit: $
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 160 days or is not completed within two (2) years of date of issue.
gnature of Owner/Contractor Date
For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS Is YOUR PERMIT
Date Permit Paid: d`' � b Receipt #' �l' Approved ,by: Ca f
Zoning]Flood Plain/U ilities•
Current Zoning: `1 Conditional Use Permit Required: Yes No
Date CUP Approved:
State Fire Marshal Required: Y s NoVariance Required: Yes No
Minimum Setbacks: Front Second Front Side Side Rear i S—
Lot Square Footage:
Length x Width: Lot Coverage %
Driveways/Sidewalks: .
Sidewalk required: Yes No
Flood Plain: Yes No
If yes, specify special requirements
BUILDING INSPECTOR REVIEW:
Sidewalk Waiver: Yes _
Date Waiver Approved:
Number of Stories
One Two Three Four
Type of Residential Structure:
Ranch ✓ Two Story Split Entry
>Four High Rise (>75 ft)
Raised Ranch Other
Rooms Bedrooms Bathrooms Fireplaces Gas "/ Electric
Egress in Basement: Required: Yes ✓ No Provided on Plans: Yes f/ No
Sleeping Rooms Living Area Other Egress JLN6LAS9ffi
Sauare Footage:
Main Level: / Second Level: Third Level
Basement: (Unfinished)/ M (Finished)
Garage: 2 bay-- 3 bay 4 bay 5+ bay
Detached Garage: Pole Barn:
Addition: Remodel:
Porch: Front Rear Side
Deck that affect setbacks: Rear Front Side
Occupancv Classification:
Assembly, theaters, with stage Assembly, theater, without stage
Assembly, nightclubs Assembly, restaurants, bars, banquet halls
Assembly, churches Assembly, arenas
Assembly, general, community halls, libraries, museums
Business Educational Factory and industrial, moderate hazard
Factory and industrial, low hazard High Hazard, explosives
High Hazard HPM Institutional, supervised environment
Institutional, incapacitated Institutional, restrained
Institutional, day care facilities Mercantile Residential, hotels
Residential, multiple family Residential, one- and two-family
Residential, care/assisted living facilities
Storage, moderate hazard Storage, low hazard Utility, miscellaneous
Is building required to be protected by automatic fire sprinkler system?"
No
Only partially in some areas or rooms Please Specify
Yes If yes, the standard to which the sprinkler system will be designed:
NFPA 13 NFPS 13R NFPA 13D
Driveway Grade: (percentage) (Dale will review new residential construction) (Al
will review all second access requests and industrial and commercial driveway requests)
Required Off Street Parking:
RESIDENTIAL - NEW CONSTRUCTION:
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
All other permits valued under $10,000
No Deposit Fee
Permit fee is: I'
Finished sq/ft area e` X$88 $ VAO,5•'00
(not including finished basement area)
Finished basement sq/ft area
X $53 $
Unfinished basement sq/ft area
X $26 $�.� •'�
Garage sq/ft area
X $20 $ 0j a . ' 0
�
Total Valuation:
$ °0
$ 0 TO $ 1,999
$ 15.00
$ 2,000 TO $ 4,999
$ 25.00
$ 5,000 TO $ 9,999
$ 50.00
$ 10,000 TO $ 49,999
$ 50.00 + $ 5.00 per 1000
$ 50,000 TO $ 99,999
$ 250.00 + $ 4.50 per 1000
$ 100,000 TO $ 199,999
$ 475.00 + $ 4.00 per 1000
$ 200,000 TO $ 399,999
$ 875.00 + $ 2.50 per 1000
$ 400,000 TO $ 999,000
$ 1,375.00 + $ 1.25 per 1000
$ 1,000,000 AND OVER
$ 2,125.00 +$1.00 per 1000
Issuance Fee:
Total Permit Fee = Deposit/Permit Fee/Issuance Fee
$ 15.00
Ofd 00
$ a' tie3
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Business/industrial/Educational/Assembly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
All other permits valued under $10,000
Permit fee is:
Finished sq/ft area' X $60 $
$ 0 TO $
1,999
$ 2,000 TO $
4,999
$ 51000 TO $
9,999
$ 10,000 TO $
49,999
$ 50,000 TO $
99,999
$ 100,000 TO $
199,999
$ 200,000 TO $
399,999
$ 400,000 TO $
999,000
$ 1,000,000 AND OVER
Permit Fee calculated from chart above
Issuance Fee:
Total Permit Fee = Deposit/Permit Fee/Issuance Fee
Additional Comments:
No Deposit Fee
$ 15.00
$ 25.00
$ 50.00
$ 50.00 + $ 5.00 per 1000
$ 250.00 + $ 4.50 per 1000
$ 475.00 + $ 4.00 per 1000
$ 875.00 + $ 2.50 per 1000
$ 1,375.00 + $ 1.25 per 1000
$ 2,125.00 + $1.00 per 1000
E
$ 15.00
Approved
Contingent On Approval by Fire Marshall
Meet IBC, IPC, IMC and NEC Code Requirements
Sleeping Rooms below Story and in Basement required to have egress
For Office Use Only
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes No
Application Date: 11.
Permit Fee: $ I& --3 : 7
JOB ADDRESS
xeit
LEGAL
DESCR. 71 SEE ATTACHED SHEET
Ow 1 MAILADDRESS ZIP HOME PHONE
Z.
6
L WORK/CELLPHONE
3 CONT T0R ., MAILADDRESS s PHONE HOMEPHONE
WORKJCELL PHONE
4. Class of Work: ® NEW RESIDENTIAL ® NEW COMMERCIAL ® REMODELING/ADDITIONS ® UPGRADE SERVICE
5. Describe Work:
6. Current License on File yes ® No ® NA Completion Date
New Service Fee = (Amp Fee + $2.00 per branch circuit)
ELECTRICAL PERMIT FEES
1-100 Amp Fee ............................ $ 13.00
Upgrade Existing Service ...... $10.00
101-200 Amp Fee ............................ $ 18.00
Temporary Service ................ $10.00 %
201-300 Amp Fee ............................ $ 30.00
Fire Alarm System ................. $10.00
301-400 Amp Fee ............................ $ 42.00
Signs ..................................... $15.00
401-500 Amp Fee ............................ $ 55.00
501-600 Amp Fee ............................ $ 67.00
Miscellaneous Apparatus ...... $11.00
601-700 Amp Fee ............................ $ 80.00
AC/DC Circuit ........................ $5.00
701-800 Amp Fee ............................ $ 92.00
801-900 Amp Fee ............................ $105.00
Commercial/Multi-Family and All Upgrades:
901-1000 Amp ................................. $117.00
# of Circuits x $2.00
IF OVER 1000 Amp
Amp Fee
1 st 1000 Amp Fee ....................... $117.00
Each additional 100 Amps ........... $ 13.00
Amp Fee + Circuit Total
New Residential: (Finished Area)
NOTICE
Single/Two Family Dwellings
I hereby certify that I have read and examined this
sq. ft. x .045 /
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of
Modular/Manufactured Homes ....... $30.00
work will be complied with whether specified herein or not.
Receptacle/Switch Outlets
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local
Fixtures -x $.75
law regulating construction or the performance of
Smoke Detectors x $3.00
construction.
Residential/Commercial Appliance
# Fixed Outlets x $3.00
�
` `
Motor(s) x $3.00
;� l 11
Power Apparatus (220 Volts)
# Apparatus x $3.00
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
Permit Issuance Fee ............. $15.00
DATE
TOTAL
Comment:
PROPERLYWHEN DASPACE)
Approved By:
POUNDS PRTG.-Blair, NE Rev. 11/99
®mise
of O
September 19, 2008
Pat Mallette Construction
1057 S Hwy 30
Blair NE 68008
Re: 12618 -Residential New Construction -Condos
Dear Mr. Mallette,
This letter is to inform you the above permit 12618 will expire on October 31,
Please be advised that you will need to contact our office no later than Thursday
October 30, 2008 to request a final inspection of this project, or renew this permit for an
additional one -(1) year period at a cost of $270.00.
Enclosed, please find a copy of the building permit for your reference. If you
have any questions regarding this issue, feel free to contact me.
Thank you in advance for your cooperation in this matter.
Sincerely,
3pda.
Brenda Wheeler
City Clerk
Enc.
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 a E-mail cityofblair@cLblair.ne.us
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
THANKYOU mEsPTH|SCOPY FOR YOUR RECORDS.
Pounds Printing, Blair, NE 68008
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79'
226.
r
Software r a7"
Project Title_ vvestfork Condo F
Report Datee: =1-0106
Data filename: C:iProgram F�leslCheckiRESchecklCondo F.rck
Energy Code:
200011ECC
20.0
Location:
Blair, Nebraska
1392 13.0
Construction Type:
Single Family
Window 1: Vinyl Frame:Double Pane with Low-€:
glazing area Percentage:
9%
7
Heating Degree Days:
6506
0.330
Construction Site:
Window 3: Vinyl Frame:Double Pane with Low -E:
Owner/Agent:
Blair, NE 6800" 8
8
Pat Mallette
ail
0330
Pat Mallette Const. Co., Inc.
Window 5: Vinyl Frame:Double Pane with Low -E:
8
410511 South HWY. 30
3
Window 6: Vinyl Frame:Double Pane with Low -E:
Blair, NE 68008
0.330
3
402-42658282
Designer/Contractor.-
Gelling
esigner/Contractor:
Permit #
Permit Date_—
REScheck
1
Gelling 1: Flat Ceiling or Scissor Truss:
1500 46.0
20.0
39
Wall 1: Wood Frame, 16" o.c.:
1392 13.0
3.5
84
Window 1: Vinyl Frame:Double Pane with Low-€:
20
0.330
7
Window 2: Vinyi Frame:Double Pane with Low -c:
20
0.330
i
Window 3: Vinyl Frame:Double Pane with Low -E:
24
0.330
8
Window 4; vinyl Frame -.Double Pane with Low -E:
ail
0330
10
Window 5: Vinyl Frame:Double Pane with Low -E:
8
0,330
3
Window 6: Vinyl Frame:Double Pane with Low -E:
8
0.330
3
Door 1: Solid-
21
00,150
3
Door 2: Solid:
210.150
3
Door '0: Glass:
—1
V, 370
8
Basement Wall 1: Masonry Block with Empty Cells:
1392 0.0
1.9
160
Furnace 1: Forced Hot Air: 95 AFUE
Air Conditioner 1: Electric Central n:s: 13 SEES;
Comgldance Sfaternenf, The proposed building design described ;dere is consistent with the building plans, specifications, and other
calculations guhrnitted with the Hermit nnlieatinn, Tile proposed building he,-, been designer to meet the 200011 Cil requirements in
REScheck Versl n 3.7.3 and to comply with the mandatory requirementslistedIn the REScheck Inspection Checklist.
�ik K\sMs—
—
BuilderiDesigner Company Name ate
Westfork Condo F Page 1 of 1
BUILDING INSPECTION REPORT
i
:;4TY OF BLAIR ❑ WASHINGTON COUNTY ❑ 07
r. LOCATION OF INSPECTION: ' n 7 % r% �
NAME OF OWNER• % 7 ��%� CONTRACTOR C) "GL7IiL-f'
DATE INSPECTION REQUESTED: W�TIME INSPECTION REQUESTED: /'T % PERMIT NO_ / �1 CJ
�* %g --9-U'7
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED
COMMENTS: ❑ ❑
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED
❑ ❑ El PARTIAL
ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED
❑ PARTIAL ❑ ❑
COMMENTS:
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED
El
COMMENTS: F1
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
❑ PRESSURE TEST
COMMENTS:
❑ OCCUPANCY GRANTED/ )❑ CONNDITIONAL OCCUPANCY GRANTED
AT/1TC(/D L'L,T A DULL.
DATE OF INSPECTION MADE_
FAXED OPPD\BURT REA TO CONNECT SERVICE:
PASSED FAILED
❑ ❑
T -FD l
-J
1210 112007
1
'�_.R ._ � _.. 11�.i"'r1
[� -;CITY OF BLAIR
Oslo] oil U DRJ ll
❑ WASHINGTON COUNTY
LOCATION OF INSPECTION:
NAME OF OWNER �F yz �.
❑ OTHER
J/ t
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑
ur
PASSED
FAILED
•
6
❑
DATE INSPECTION REQUESTED:-
TIME INSPECTION REQUESTED , -,,",L', a PERMIT N0:
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑
FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE "'0, -',WATER SERVICE
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
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑
FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
COMMENTS:
- ---------- - -------------
F-1
-------❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS-
INSPECTOR:' / DATE OF INSPECTION MADE: ' a TIME•c
FAXED OPPDIBURT REA TO CONNECT SERVICE:
❑ , CITY OF BLAIR
LOCATION OF
❑ WASHINGTON COUNTY ❑
NAME OF OWNER �` f f �
CONTRACTOR ,. �`
• ' ° '�
DATE INSPECTION REQUESTED
- rt'- k
TIME INSPECTION REQUESTED +rj ! ' "
PERMIT NO:
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑ PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑ ROUGH IN ❑ FINAL' ''PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑ PARTIAL
4
El
COMMENTS:'
' , t
MECHANICAL: ❑ ROUGH -IN ❑ A/C
❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
PLUMBING: ❑ GROUNDWORK ❑
ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑ PRESSURE TEST
❑
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CyONDITIONAL OCCUPANCY GRANTED
17A ,/
�/ �'
NOTES/REMARKS•
m
AXED OP R A
Z_:�) �,
��
u
DATE OF INSPECTION MADE: _ TIME.
TO CONNECT SERVICE: ON
❑ CITY OF BLAIR
LOCATION OF INSPECTION:
13UILDING INSPECTION REPORT
❑ WASHINGTON COUNTY ❑ OTHER
9 A ti r
NAME OF OWNER ! CONTRACTOR:_>' I
�f
DATE INSPECTION REQUESTED: Ru;x
TIME INSPECTION REQUESTED•s PERMIT NOL--
TYPE
O• TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: , ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL -%.PASS5D FAILED
COMMENTS
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
El
PARTIAL
❑
1:1COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
El
PARTIAL
El
ElCOMMENTS:
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIALS?
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
El
El
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
INSPECTOR Aw°`''k' DATE OF INSPECTION MADE: /; '-/ 7 - 6 2 1 TIMI /
FAXED OPPDTURT REA TO CONNECT SERVICE:
❑� ,,CITY OF BLAIR
LOCATION OF
NAME OF OWNERL_�
❑ WASHINGTON COUNTY
[] OTHER_
�$ s
DATE INSPECTION REQUESTED -TIME INSPECTION REQUESTED PERMIT NO•
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
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
PASSED
FAILED
❑
F]
COMMENTS:
PLUMBING: _,
GROUNDWORK ❑ ROUGH -IN ❑ FINAL [I WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
F]PRESSURE
TEST
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
INSPECTO �''I . � / DATE OF INSPECTION MADE: !` �� to TIM 04—
FAXED
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
°.::.CITY OF BLAIR
LOCATION OF
BUILDING r , REPORT
❑ WASHINGTON COUNTY
NAME OF OWNER ' `�� r
ROUGH -IN ❑ A/C
❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIALS
PASSED
FAILED 4
CONTRACTOR-
ONTRACTOR
❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
DATE INSPECTION REQUESTED- I fp
DATE
TIME INSPECTION REQUESTED
x` - PERMIT N0:
❑
❑
COMMENTS:
TYPE OF INSPECTION REQUESTED:
GROUNDWORK ❑
❑ CONFERENCE
❑ STATUS CHECK l
BUILDING: ❑ FOOTING ❑ DECKFOOTING ❑
FRAMING ❑ DRYWALL ❑
FINAL❑ PARTIAL
PASSED FAILED
❑ PARTIAL
/ �'
COMMENTS:
❑ ❑ fi
COMMENTS:
ROUGH -IN ❑ A/C
❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIALS
PASSED
FAILED 4
UTILITIES:
❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
❑ PARTIAL
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑
ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
ELECTRICAL I'ROUGH IN ❑
FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSE FAILED
❑ PARTIAL
/ �'
COMMENTS:
❑
COMMENTS
ILI
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
MECHANICAL: ❑
ROUGH -IN ❑ A/C
❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIALS
PASSED
FAILED 4
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑
ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
,1
s`
t
a
s
DATE OF INSPECTION MADE: ! " ��i TME -_, o
j
FAXED OPPD\BURTREA TO CONNECT SERVICE: ON BY a M,'(e
BUILDING •ECTION REPOR
CITY OF BLAIR ❑ WASHINGTON COUNTY
� r
LOCATION OF INSPECTION
' IA—
PASSED
FAILED
❑
PARTIAL
❑
NAME OF OWNER t
= �r ""CONTRACTOR-
ONTRACTOR
dt
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
DATE
DATE INSPECTION REQUESTED-
TIME INSPECTION REQUESTED
PERMIT
N0
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑ FOOTING
❑ DECK FOOTING � FRAMING ❑ DRYWALL ❑
FINAL PARTIAL
PASSED FAILED
PASSED
FAILED
El
COMMENTS:
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
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 ❑ FINALPARTIAL
PASSED
FAILED
❑
COMMENTS:
PLUMBING: ❑ GROUNDWORK_. ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED $`;PARTIAL PASSED FAILED
COMMENTS: ❑ PRESSURE TEST / six lees ❑
V �'j' JJ
❑ OCCUPANCY GRANTED n CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
t,
114A(vU Lr Ne
m
s
INSPECTOR— 0 ✓�'5--� DATE OF INSPECTION MADE: 4 / ` TIME- 'l
d
BY
FAXED OPPD\BURT REA TO CONNECT SERVICE: OP
a
CITY OF BLAIR ❑ WASHINGTON COUNTY
LOCATION OF INSPECTION I R'
jl { r k g L r
NAME OF OWNER -I ' Kk- : L D I—
U KUM , 0 , r
El
CONTRACTOR��
DATE INSPECTION REQUESTED ` TIME INSPECTION REQUESTED a ,'° ,� ILA, PERMIT NO'
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED
COMMENTS: ❑ ❑
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED
F1 PARTIAL
❑ ❑
COMMENTS:
ELECTRICAL: ,,❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED ILED
❑ PARTIAL ❑
COMMENTS:
MECHANICAL: ❑
ROUGH—IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH—IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS: — e-)
INSPECTOR DATE OF INSPECTION MADE:
FAXED OPPD\BURT REA
TO CONNECT SERVICE:
BY
TIM • r
-CITY OF BLAIR ❑ WASHINGTON COUNTY
,OCATION OF INSPECTION• J
DAME OF OWNER• / Glr
❑ OTHER
)ATE INSPECTION REQUESTED -Z �f l TIME INSPECTION REQUESTED- J L 12 I q / �`l - PERMIT
CYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑ FOOTING ❑ DECK FOOTING XFRAMING ❑ DRYWALL ❑ FINAL 'PARTIAL
PASSED
FAILED
❑
"OMMENTS:
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑ PARTIAL
❑
❑
"OMMENTS:
ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑ PARTIAL
❑
❑
�OMMENTS:
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
20MMENTS:
PLUMBING: GROUNDWORKS ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PRESSURE TEST 6v` 7, LQ
COMMENTS:
PASSED
FAILED
El
] OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS -F
`ej
_ J --2
INSPECTOR �/ -%� :%%f / DATE OF INSPECTION MADE: �f T'�1
z _ -
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
04119/2010 0142 PM
e —
m.
I
j
!;^-
BUILDING INSPECTION REPORT
CITY OF BLAIR ❑ WASHINGTON COUNTY E:l OTHER
LOCATION OF INSPECTION, -
NAME OF OWNER- A I CONTRACTOR ,,
DATE INSPECTION REQUESTED- TIME INSPECTION REQUESTED•
TYPE OF INSPECTION REQUESTED:
BUILDING: ❑ FOOTING ❑ DECK FOOTING
COMMENTS:
PERMIT NO:
E:l CONFERENCE Fl STATUS CHECK
FRAMING E] DRYWALL F-1 FINAL El PARTIAL PASSED FAILED
El
UTILITIES: F]
SEWER TAP [I SEWER Ll SEPTIC F-1 WATER TAP F1 REMOTE [-I WATER SERVICE
PASSED
FAILED
F1
PARTIAL
COMMENTS:
ELECTRICAL: F]
ROUGH IN n FINAL F-1 PERMANENT SERVICEE] TEMPORARY SERVICE F1 PRECONNECT
PASSED
FAILED
❑
COMMENTS:
PARTIAL
MECHANICAL�.'12-1ROUGH-IN Fl A/C F I FURNACE El RADIANT HEAT E] FINAL XPARTIAL
LASSED
FAILED
COMMENTS:
E K- �,/ !*:!&- 0 u eup— e,
PLUMBING: F-1
GROUNDWORKn--ROUGH-IN El FINALE] WATER METER INSTALLED El PARTIAL
PASSED
FAILED
El
PRESSURE TEST
El
El
COMMENTS:
F] OCCUPANCY GRANTED F-1 CONDITIONAL OCCUPANCY GRANTED
INSPECT DATE OF INSPECTION MADE: E -
FAXED OPPD\BURT REA TO CONNECT SERVICE:
POFnI I%sm( kN•.M)DM—
BY
7/6/209
I�
0
,D,, -,,CITY OF BLAIR
LOCATION OF
❑ WASHINGTON COUNTY ❑
NAME OF OWNER`
DATE INSPEC3ION REQUESTED r TIME INSPECTION REQUESTED PERMIT NO"
n TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
El
PARTIAL
El
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FlNAL. ❑,P8_RMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑
COMMENTS:
PARTIAL r r° I'll 4
1, 7
❑
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIALS
PASSED
FAILED
❑
PRESSURE TEST
❑
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
d
DATE OF INSPECTION MADE: — T� `
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON B
BUILDING INSPECTIO N REPORT
b�'CITY OF BLAIR F1 WASHINGTON COUNTY El OTHER
n� o
C -11i f
V'l i _1f
LOCATION OF INSPECTION x i
NAME OF OWNER- CONTRACTOR.
DATE INSPECTION REQUESTED:— TIME INSPECTION REQUESTED r, PERMIT NO- zLi
TYPE OF INSPECTION REQUESTED: F1 CONFERENCE
F1 STATUS CHECK
BUILDING: F]
FOOTING F] DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑f FINAL "R."PARTIAL
PASSED
FAILED
COMMENTS: ll ", , " , "'i-, ,
v A k 0, v, j
/N
El
UTILITIES: F -I
I SEPTIC 'F� WATER TAP WAQR SERVICE
SEWER TAP F -I SEWER F -1 REMOTE F�
PASSED
FAILED
E
PARTIAL
El
El
COMMENTS:
ELECTRICAL: F -I
ROUGH IN F -I FINAL ❑ PERMANENT SERVICE F] TEMPORARY SERVICE F PRECONNECT
PASSED
FAILED
F -I
PARTIAL
F -I
F -I
COMMENTS:
MECHANICAL: F]
ROUGH -IN [_1 A/C 0 FURNACE F1 RADIANT HEAT , 214F'N'AL PARTIAL
PASSED
FAILED
❑
COMMENTS:
PLUMBING: F -I
GROUNDWORK ROUGH -IN
I
F [721�1 -141NAL El WATER METER INSTALLED &I -PARTIAL
PASSED
FAILED
F1
PRESSU RE TEST
El
COMMENTS:
F -I OCCUPANCY GRANTED F-1 CONDITIONAL OCCUPANCY GRANTED
NOTES[REMARKS:
L ,(j P�+eLA_ (o
LK
i L. J- "A -c k-
2/
INSPECTOR- ?kZd�
T
41
DATE OF INSPECTION MADE: E
FAXED OPPD\BURT REA TO CONNECT SERVICE:
w-
I
YCITY OF BLAIR❑
WASHINGTON COUNTY ❑OTHER
FAILED
FAILED
❑
3
f'
` f " '�
LOCATION OF INSPECTION
NAME OF OWNER-
WNERCONTRACTOR-DATE
CONTRACTOR-
r f
4' '
DATEINSPECTION REQUESTED
if
TIME INSPECTION REQUESTED Ki f PERMIT
NO
TYPE OF INSPECTION REQUESTED
❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING
❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑
SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS
ELECTRICAL. ❑
ROUGH IN",, TINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
SS
FAILED
.
1
PARTIAL u
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL,
COMMENTS:
PLUMBING: ❑ GROUNDWORK ❑ ROUGH IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
❑ PRESSURE TEST
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS-
PASSED
PASSED
❑
FAILED
FAILED
❑
FAXED OPPD\BURT REA
61
DATE OF INSPECTION MADE:
TO CONNECT SERVICE: ON BY
NCITY OF BLAIR ❑ WASHINGTON COUNTY ❑
LOCATION OF INSPECTION -
NAME OF OWNER - l"
a
l'
TIMEf
DATE INSPECTION REQUESTED <" s I. INSPECTION REQUESTED " ""$•x ?r'f" " PERMIT NO-
x
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN-' ❑ zFF NAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSE
FAI D
❑
PARTIAL1,
❑
COMMENTS
� rr w
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT FINAL❑µ PARTIAL
PASSED FAILED
COMMENTS: ❑ F-1
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
❑ PRESSURE TEST F-1 F1COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
DATE OF INSPECTION MADE: T TiMF
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
y�
❑,,,CITY OF BLAIR
LOCATION OF
NAME OF
❑ WASHINGTON COUNTY
DATE INSPECTION REQUESTED- Z r
❑ OTHER
7
CONTRACTOR
TROE INSPECTION REQUESTED / a° 4' " ' °! PERMIT NO'
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
gym'
BUILDING: ❑
FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTICI ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
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 ❑ PARTIALS
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING ❑
GROUNDWORK ❑ ROUGH—IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑"PRESSURE TEST
❑
COMMENTS
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
c
INSPECTOR- DATE OF INSPECTION MADE: TIMF,- L
FAXED OPPD\BURT REA TO CONNECT SERVICE:
04 0