BP13181
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Blair Building Permit Detail
Permit #: 13181 Issued: 4/20/2009
Completed: 4/28/2009
Location: 582 S 16th St
Owner: Judy Thompson (Holding a 50.00 Deposit)
Address: 582 S 16th St
Type: Roofing permits - All types
Valuation: 1500
Blair, NE 68008
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
40
25
50
24480
Phone:
Section:
Subdivision:
Township:
Range:
Lot: 5 & 6
Block: 2
Adding one layer of asphalt shingles to existing layer of single layer of asphalt shingles. HOLDING A 50.00
DEPOSIT UNTIL 7-20-2009.
Contractors
M/K Framing
General Contractor
Permit #
Issued
Remarks
4/20/2009
BMP
HOLDING A 50.00 DEPOSIT UNTIL 7-20-2009
4/28/2009
KAR
One layer with 3 tab asphalt shingles black 4 nails per shingle. Roof is over a 6-12 pitch.
Noted Next time both layers will have to be taken off and ice shield installed as per codes.
Inspections Date
4/28/2009
By
KAR
Final Inspection of Project
Pass
. . 1
;;.f;.I!O/rj;, i1cj 50. 00 obrt? s1,! -;-0(1 --#~f'5t"11 J!cx.f
CITY OF BLA!~",:- ~~~.t~tt'~~OUS ~!l\t-DING PERMIT . '
t 1 j ~,- "'U'" "'" " Permit # ,3 I 8/
Date: if ~ 20- () 1 Approximate Completion Date: if - 2Lf -() ci Site Plan Attached:
Estimated Valuation of Project: I/')()) . ()~,
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 X
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.)
A~ditiopal 9~script.ion ?f. project if ~e.ce~s~ry: /;i,d;{it~1/;;) r'nLl Jc~/! c.t~
(J./)fl1 tJ!)- ,J,rlun c~ TO ,jI/)d/.J.1!:i.-l"1 (j ) 1/
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PROJECT INFORMATION:
Job Address:
-,5'";;; /;:! IS) lull> ,j(l.
8'10CJ.:53/6/
Legal Description (if applicable) ,/j{!; }-/cuba'd/ttJ-) Add J.JIJo I cY6t.Jl -5;: IJJ sdC/
I I 1.../ I .,i)li (/.1<~ (r"/: BJ i, ;;1 /11/ PC-:1
Owner: / J octt./,. / /1.IJ711jo8tf7u Address: Phone#:
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fl! '/ c.../' --;I'll eV! It ,d::'" "?.:::J '7 cJ //;;;
Contractor: I ~ 1<.. :1' A CW71cRn (.1/ Phone #: 0 _J.::J ,- c7 / :r.
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Address: 3!PIPg (]o/~ c.(~ich Cell #: /y 7;;7-37;;18
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lj8C;08
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 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 $150.00 $
Original permit fee of $50,000 - $100,000 $200.00 $
Original permit fee of $100,000 - $500,000 $300.00 $
Original permit fee 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.
"Tt/1evil 1j'ZoJ~
Signature of Owner/Contractor
/1-- 96-09
Date .
For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit paid:cf,;7 ?I/C:)C{ Receipt # r.;;J .t./llg{) Approved by:. -1S' ~1'; J?~/
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 OF BLAIQ
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 BuildinQ
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
iq"7~ 7~
\,j
Contractor
City of Blair
f~ Lf-~~p ~o 9-
Date
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci.blair.ne,us ;~~',':,'JJ~;
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Promise
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
~-5?-~~3~Jndable deposit is being collected for all misc. permits.
-_c~...._..--- .
The City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) Theft of water service by the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection being done.
6) Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
I hereby agree to the above conditions, and understand that should any or
all of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
0. 7j'Lr;vIj .~0h,
Contractor/Owner
Contractor/Owner
City of Blair
(J Lj_ J-.tJ -(l 9
Date
BUILDING INSPECTION REPORT
CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
NAME OF
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il-,?f5 (Cj TIMEINSPEZONRR~~jI\~~,tf; ;;CRMIT~~~f~~~_
TYPE OF INSPECTION REQUESTED: l/~5> e .e e:;. r&:2CJ ~ D CO~NCE 0 ~TUS dfuCK
BUILDING: D FOOTING D DECK FOOTING D FRAMING 0 DRYWALL FINAL D PARTIAL
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
o PARTIAL
~~ED
PASSED FAILED
D D
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COMMENTS:
MECHANICAL: D ROUGH-IN D A/C D FURNACE D RADIANT REA T D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
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$,- 1kr^ (').. 'e
D OCCUPANCY GRANTED
DATE OF INSPECTION MADEt)lj ~ -dCtf7 TIMP') I~
INSPECTO '
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY