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BP13208 Permit #: 13208 Issued: Completed: Location: 222 Jackson St Owner: Kenneth & Rita Smock Address: 10738 Oak Park Ln Blair, NE 68008 Phone: 533 2655 Section: Township: Subdivision: WEIMERS1 , ; EN o '* Blair Building Permit Detail 7/1/2009 1/27/2010 Type: Residential - New Construction Valuation: 143990 Permit Fee: Issue Fee: Deposit Amt.: Receipt #: 863.94 25 500 24630 Range: Lot: 35 Block: Move house to this lot for new construction - one bedroom ranch on basement. Unfinished at this time. Added Garage 11-06-2009. See remarks. DEPOSIT IS FORFEITED Contractors SELF Beebe Refrigeration, Htg. & A/C, Inc. Dick's Electric Henton Trenching, Inc. Henton Trenching, Inc. SELF Remarks 6/2/2009 KAR 6/5/2009 KAR 7/6/2009 KAR 7/29/2009 HOW 7/30/2009 HOW 7/30/2009 HOW 7/30/2009 HOW 8/10/2009 HOW General Contractor Permit # Issued Heating Subcontractor M1939 11/10/2009 Electrical Subcontractor E3141 9/8/2009 Plumbing Subcontractor T1364 11/5/2009 Plumbing Subcontractor P2067 11/5/2009 Plumbing Subcontractor P2047 8/27/2009 Over laps on rebar 16" to 18" and wire tied. Clean out footings. where is grounding point to footing rebar for electrical. Where are grade stakes for proper depth of footings. Is there any pad footings required. Call for reinspection when corrected. Beam pads to be inspected later. Section 3408 of the 2006 IBC moved structures. Went out there no one was there. 1. scope-capped off existing sewer line.-ok-hw. 1. Scope: two int. pier footings-ok-hw. 1. Scope: Sill plates: provide manufacturers installation instructions for sill plate anchors. ref. 403.1.6 and 104.4. 2. Show property pins. 3. Provide silt fence at W. property line(downhill to next house) 1. Silt fence: provide silt fence at W. property line(downhill to next house.-hw. 1. STOP WORK until silt fence is installed between home on .w. side at the property line extending from the rear property line to the front property line. 8/11/2009 HOW 8/12/2009 HOW 8/27/2009 HOW 8/27/2009 HOW 10/27/2009 KAR 10/27/2009 KAR 11/6/2009 BRT 11/13/2009 HOW 11/17/2009 HOW 11/19/2009 HOW 12/14/2009 HOW 12/15/2009 KAR 12/15/2009 KAR 12/15/2009 KAR Blair Building Permit Detail 2. Provide access for inspection of steel beam bearing supports-min of 3" is required.-hw. 1. Silt fence-ok-W-p/I-extends from near back p/I to front p/I.-ok-hw. 2. Note; SHOW 3"MIN. BEARING ON AT LEAST ONE BEAM AT ONE END. 3. Provide listing and instructions for exist house bottom plate to foundation anchors-hw. 1. Code enforcement: cut weeds at back property line and a W. property line.-hw. 2. NOTE: Silt fence stakes ok-hw. 1. plumbing ground work-installation and test-ok-hw. 1. footings-stair and porch-ok-hw. As per conversaqtion with dick and dicks electric on 10-29-09 9:30am. Inspection was to be a partial rough in only for main level bathroom and laundry room. and the rough ins for that area was ok. Breakers not labeled Rough in not done in basement. Exposed wire and outlets and switch's hanging out no cover plates. No heating and water heater not hooked up. Rita came in and added the plot plan for a garage. No inspections will be done without approved plans. Plans were not submitted but added the garage to permit. 1. footings-garage-ok-note-footings and slab only-building will come later-must be less than 600sq. ft. footings are 12" deep. 1. footings-driveway-ok. 1. plumbing rough-in-temp. vent for kitchen sink ok until Jan. 1. Provide listing for flex gas line to show bend radius allowed. Outlets not all installed as per code for spacing in habitable rooms or for kitchen counters. Arc Fault protection required for new branch circuits into bedrooms. Romex in cold air return above furnace. Note when a house is moved to a new location will will electrical is to be brought up to code for outlets required GFCI protection as if it were a new house being built. Upstairs electrical is safe smoke detectors are working. Blair Building Permit Detail 12/21/2009 HOW Provide Street Address on front of house. 1/7/2010 BMP Mr. & Mrs. Smock have until January 21, 2010 to complete safety issues: 1. Light Switch installed at bottom of the basement stairs 2. ARC Fault installed for upstairs bedroom. 3. Address of property located on front of house. 1/7/2010 BMP The Smocks have until June 30, 2010 to have the whole project completed. Please see agreement in file or laserfische. 1/7/2010 BMP Per Brenda Deposit is forfeited. 1/25/2010 HOW 1.approval is pending electrical final. 2. Apply for permit for basement remodel.. 3. Install smoke alarm outside bedroom (basement) when remodel is done. 1/25/2010 KAR Upstairs only. Hallway outlet hot neutral reversed. Kitchen counter left side of range is to have required outlet as per code. Cover and protect romex basement switch's and romex above panel. 14 days to correct. Inspections Date By 6/2/2009 KAR Footings Fail 6/5/2009 KAR Footings Pass Partial 7/6/2009 KAR Conference Fail 7/29/2009 HOW Sewer Lines Pass 7/30/2009 HOW Footings Pass 7/30/2009 HOW Framing Fail 7/30/2009 HOW Ditches Fail 7/30/2009 HOW Ditches Fail 8/10/2009 HOW Conference Fail 8/11/2009 HOW Conference Pass 8/12/2009 HOW Conference Fail 8/27/2009 HOW Footings Pass 8/27/2009 HOW Plumbing Groundwork Pass 10/8/2009 KAR Electrical Permanent Service Pass 10/27/2009 KAR Electrical Rough-ins Pass Partial 11/5/2009 HOW Water Service Pass 11/5/2009 HOW Sewer Tap Pass 11/13/2009 HOW Footings Pass 11/17/2009 HOW Footings Pass 11/19/2009 HOW Plumbing Rough-ins Pass Partial 12/11/2009 HOW Status check Fail 12/15/2009 KAR Electrical Final Fail Partial 12/21/2009 HOW Status check Pass 1/25/2010 HOW Final Inspection of Project Pass Partial 1/25/2010 HOW Mechanical Final Pass 1/25/2010 1/25/2010 1/27/2010 HOW KAR KAR Blair Building Permit Detail Plumbing Final Electrical Final Electrical Final Pass Fail Pass CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT Permit# 13CJoB Date: 5) I 5- I 0 c1 Approximate Completion Date: / p- 3 (- 0 cr Site Plan Attached: 1 REScheck Attached: Complete Plans Attached '" (\'\0 'I1f\3 +fl)(Yl 20 L,cl vJ (l.5: h ( ('l:~ j-f)(\ "\(s\ D ilL t4 Application for: Residential-A- 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 Sign Erecting, Awnings _ Decks/Handicap Ramps (plot plan required) _ Satellite Dishes/Radio Antenna/Cell Towers (plot plan required) _ Other Public Water: Yes_ No Private Well If yes, responsible entity: Blair OPPD Line Kennard Agreement needed: _ Date Agreement Received: _ Public Sewer: Yes_ No Septic Drawing Provided: _ If yes, responsible entity: Blair _ Kennard_ County Road Permit Required: Yes_ No _ Submitted: Yes _ No _ \1\ D~ e.,haUs'f_ to ,.'1\\:, I d- -\'of:.. ne cO " ( - et\t II "'<:.,1 ( o'{1\6 Utilities: Additiona/Oescription of project if necessary: ~D(\.)'+{ \J cH (j'(\ ~ \ l:Y: ( ') ('{'\ :A f .r- { e Proiect Information: Job Address: ~:;ld l 3 ct (J~O('\ s-f Legal Description (if applicable) \<-Q{\(\ -e. t-t' . Owner: \i<r+c{ S N\ OcJC J)G., vJ t ( N\.e { 'S:, ~q()059,;z(3 AdcL Lu-t :5 S- If If pC-. '3b .c9t/A6 Contractor: __14('\(1e. -vh (, SOv1'f\~ Address: I () "13 <:~ OulL ~ld~{. Phone#: K \ '~t\ S ('(\OeJe Phone #: ,Sj 3"lJpS'S- ~ Gf);\\-fUJt./ 0 (Cu.);)ccrJ..) Address: Cell #: Lf2.]-50lfcJ 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,?ord'nances of the City of Blair and the State of Nebraska, I understand that this permit is void if work is not commenced within 180 d ys r,is not comPlet.'.7~.d;1Nithin two (2) years of date of issue. :J/i .,.~) --/j)~C}7 , Signa ulfU)f Owner/Contractor Date ZONING REVIEW: Zonin Flood Plain Utilities: . , Current Zoning: l ~ Conditional Use Permit Required: Yes _ NO-X. Date CUf ,Approved: State Fire Marshal Required: Yes _ No ~ Variance Required: Yes _ No Minimum Setbacks: Front ~ Second Front Side 4 Side _ Rear Lot Sauare Foota~e: Length x Width: Lot Coverage % Drivewavs/Sidewalks: ,I Sidewalk required: Yes-*" No_ Sidewalk Waiver: Yes Date Waiver Approved: Preexisting Garage requires driveway to be less than 3' from property line: Yes_ Approved by: No Flood Plain: Yes NO~ If yes, specify special requirements: BUILDING INSPECTOR REVIEW: f Stories Two Three Four >Four High Rise (>75 ft)_ T e of Re "dential Structure: Ranch Two Story _ Split Entry _ Raised Ranch _ Other Rooms _ Bedrooms _ Bathrooms _ Fireplaces _ Gas_ Electric _ Egress in Basement: Required: Yes _ No _ Provided on Plans: Yes No Sleeping Rooms Living Area Other Egress Sauare Foota~e: Main Level: _I \ Cj G Basement: (Unfinished) Garage: ~I k Detached Garage: Addition: Porch: Front Rear Deck that affect setbacks: Rear II~D fJ/k- Second Level: Third Level (Finished) 2 bay_ 3 bay_ 4 bay_ 5+ bay Pole Barn: Remodel: Side Front Side Occupancy 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 _ (section continued on next page) High Hazard HPM Institutional, incapacitated _ Institutional, day care facilities_ Residential, multiple family _ Residential, care/assisted living facilities Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous _ Institutional, supervised environment_ Institutional, restrained _ Mercantile Residential, hotels _ Residential, one- and two-family Is buildim! reauired to be protected bv automatic fire sprinkler svstem?" 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: 20% grade or less? Yes _ No_ (Dale will review new residential construction. AI will review all second access requests and industrial and commercial driveway requests) Required Off Street Parking: Permit Fee Calculation: Buildinr:! Permit Deposit Fee: Commercial, new homes and residential additions/remodels/accessory buildings valued $10,000 or greater $ -50D .00 Fee - $500.00 Residential additions/remodels/accessory buildings valued under $10,000 $ Fee = $200.00 All other permits Fee = $50.00 $ RESIDENTIAL - NEW CONSTRUCTION: Permit fee is: Finished sqjft area t 14 0 (not including finished basement area) Finished basement sqjft area Unfinished basement sqjft area l \ q D Garage sqjft area Total Valuation: X $92 X $56 X$29 X$25 $ I () Cf, qliO. bD $ $ $ $ J q.. 3J q'lO .o{) 81.03, '1 tf 25.00 ;;: Be8.qLf.....5'00.tw 1388. '1'1 <~LfI5/D.DO I l 00 Total Valuation I ...., ::s J qqO. Multiplied by 0.006 = $ Issuance Fee: $ Total Permit Fee = Deposit + Permit Fee + Issuance Fee $. RESIDENTIAL - ADDITIONS / REMODELS and COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS: Business/I nd ustria I/Ed ucationa 1/ Assem bly/Factory/Storage/Utility *Porches with roofs/screened patios are considered additions Construction valuation computation: Sqjft area X $63 Except for the following: Accessory Buildings & Interior Remodeling Proiects: sqjft area X $43 Pole barns with no hard surface floor: sqjft area X $25 Sign ErectimUAwnin~s and Decks/Handicap Ramps: sqjft area X $25 (Minimum valuation of $2000) Construction valuation computation: Finished sqjft area X$ $ Construction valuation is ...................................Permit fee is: $0 TO $50.......................................................... $0 $51 TO $500........................................................$25 $501 TO $2,000........................................................$25 + $3 per additional $100 $2,001 TO $25,000........................................................$70 + $13 per additional $1,000 $25,001 TO $50,000..................................................... $370 + $10 per additional $1,000 $50,001 TO $100,000..................................................... $620 + $7 per additional $1,000 $100,001 TO $500,000..................................................... $970 + $5 per additional $1,000 $500,001 TO$1,OOO,OOO ..................................................$2,970 + $4 per additional $1,000 $1,000,001 AND OVER ..................................................$4,970 + $3 per additional $1,000 Permit Fee calculated from chart above Issuance Fee: $ $ $ 25.00 Total Permit Fee = Deposit + Permit Fee + Issuance Fee Additional Comments: Approved by: Date: 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 ."1t?C .{/(.l Receipt # {,:JUII/l:.3 rJ Deposit Paid by for return to: Building Inspection Pouch given: Yes _ No 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: II - .5 - C) 9 Job Address Comments: Notice I 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 work will be complied with whether specified herein or 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 performance of construction. \ /J '/7;L /, ili~ ;:"/, f - -' , , I^'--, ~ I Signature of Contractor or Authorized Agent il J_~ /'2-~ / d 5:> Date " ( "it\:> U\:..IJ J 'V '-,..... '\t' 1lL in ~ ~~, }llCi\...~- ' J 3:;;08 P 2067 K'.OO Permit Fee: $ ,):5 ' t:j. Zip h p~fr- c:9b55 Phone Zip o Alteration 0 Repair 0 Replacement J/llli PLUMBING PERMIT FEES 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_ Additional Sinks............... ......$6.00 x Slop Sink/Laundry Tray/Drain.....$6.00 x_ Water Heater......... ........... .....$10.00 x Outside Water Faucet...................$6.00 x Drinking Fountain........................$6.00 x Backflow/Grease Trap........... ..$15.00 Water Service..................... ..$15.00 Sewer......................... ........$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 ~ ~ J5 ,DO 1.5'.00 Permit Issuance Fee................ .$25.00 Current License on File Comment: Yes 0 No Total o N/A WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT I Approved By: ell;, ;?t -f ..IU.iJMJ Rev. 2008-10 3 , "" MECHANICAL PERMIT APPLICATION , Jurisdiction of City of Blair, Nebraska ( .'2.;;;08 218 South 16th Street U Blair, Nebraska 68008 Fax (402) 426-4195 M 1939 (402) 426-4191 ~ Application Date: II/I/) ,/01 Job Address -'''' '''1, ""')" o<'~ C7 Owner '}/ ' L 1. .A.. 1 TC2 Contractor <''/) 2, 3, Class of Work: Describe Work: 4, .t:::'~. tJ {) Permit Fee: $ i-Jc-J &1. Zip Phone Zip Phone 'Q;.Kew y}J" Cilctltidal Heat Pump Central AlC Furnace f9/J, 000 I Tons Tons # of Units BTU/H AlC Furnace Completion Date: Boiler Chart BTU Fee 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 Notice I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws 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 authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. o Addition 0 Alteration 0 Repair 0 Replacement 1 Ji~t(} /ktuU/ MECHANICAL PERMIT FEES Furnace/Heat Pump/Air Conditioner (Per Unit) / c.:: () 0 Up to and including 100,000 BTU / 3Ton.................... ........$15.00 Furnace/Heat Pump/Air Conditioner (Per Unit) Over 100,000 BTU / 3 Ton.......................................... ...$25 .00 Refrigeration Units/Coolers/Lines/Compressor - Commercial (New or Replacement) (Per Unit) . .. .. . .. . .. . . .. . .. . .. . .. . .. .. . . .. .. . .. . .. . . . . . .. .. . .. . .. .. .. . .. . .. . .. .. .. . .. ..$15.00 Boiler (use BTU Chart to left)... ......... ........ Appliance Vent/Fans..................... ...$10.00 Duct System................................ ..$15.00 //).()() Gas/Air Outlets.................First 5 x $6.00 ...... ...Additional x $1.00 Radiant Heat Systems/Gas/Water Piping System..................... ... ..... ...$50.00 Modular Home... ...... ... ................ .., $50.00 Permit Issuance Fee.................... ..... .$25.00 d$.' Ot) Total 65. t) a Current License on File "'I- Yes 0 No 0 Nj A Comment: WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT I Approved By: Ji3 '" j/J I Jt(1.tt-J I Rev. 2008-10 T f I D JAN 0 8 I !3 208 ';J """,... ~_ t<-_<iF AGREEMENT LEGAL DESCRIPTION: Lot 35, Weimers Addition, Blair, Washington County, Nebraska ADDRESS: 222 Jackson Street This agreement is entered into on December 22, 2009 by and between Kenneth and Rita Smock, husband and wife, hereinafter referred to as "Smocks" and the City of Blair, Nebraska} hereinafter referred to as "City". As of December 21, 2009, it was determined the Smocks had taken up residence in the above described real estate prior to obtaining temporary occupancy and/or a final inspection from the City Building Inspector. Based on this information, the following requirements will be met within the timeframe stated or the City will require the Smocks to vacate the property until such time all items below are completed: 30-Dav Completion of Life Safety Issues: 1. Light switch installed at bottom of the basement stairs. 2. ARC Fault installed for upstairs bedroom. 3. Address of property located on front of house. 6-Month Completion (June 30, 2010): 1. One (1) GFI outlet installed in kitchen by the door. 2. Spacing of outlets in ALL rooms in the upstairs must be corrected to meet current code. 3. One (1) GFI outlet installed outside the front porch. 4. Comply with Kris Robinson's determination regarding the romex in the cold air return. 5. Basement insulation installed to meet current code. 6. If drywall is removed in any of the rooms upstairs, the insulation will be installed to meet current code. 7. Final inspection obtained prior to June 30,2010. NOTE: The $500.00 building deposit has been forfeited due to occupying the residence prior to temporary occupancy or a final inspection being authorized by the City Building Inspector. This Agreement shall be binding upon and inure to the benefit of the parties hereto, their successors and assigns. by Phil Green, Assistant City Administrator /' /I /} /7_ lY~/\...J STATE OF NEBRASKA ) ) :ss: WASHINGTON COUNTY ) The above and foregoing Agreement was acknowledged before ,me, a Notary Public, by Phil Green, Assistant City Administrator, on behalf of the City, this~day of December, 2009 and he acknowledged the execution of the foregoing Easement to be his voluntary act and deed for the purposes therein set forth. V-(~~J\ uu2.- \\ l0\;1 ~ Notary Public ffiAL~. _Ii'" KATHERINE I), LOUDNIE ) com~. Exp. June 17. 2012 q~~~~ ~ Kenneth Smock &~~ Rita ock STATE OF NEBRASKA ) ) :ss: WASHINGTON COUNTY ) The above and foregoing Agreement was acknowledged before me, a Notary Public, by Kenneth and Rita Smock this %)';11 day of December, 2009 and they acknowledged the execution of the foregoing Easement to be their voluntary act and deed for the purposes therein set forth. ILCllt1 ~n LIlL OLav AAv-- Notary Public Nm~\RY - State of Nebraska ERn~E D. lOUDNE Comm. Exp. JIm 17. 201 ~ , ....~, 'f& If! N I If Jjll( ~ ore ') '\N T1I J 3;2{)8 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: /I-~- t2!i- Job Address Contractor I. 2. e/J1 rtrn 3. Class of Work: Describe Work: 4. Comments: Notice I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws 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 authority to violate or cancel the provisions of any other state or local law regulating construction or the perfo,~,ance 0, f const, ruction. ,;/ /}" J _I-- o --?~/~ ,l- -./(;<4'-0 "'sIgnature of contractozr or, ", uthorized Agent II --1' . :?I/t>f Date T 1364 c') /}/, () 0 Permit Fee: $ ex (/&/. ~ els"'t'7'J or! Zip Phone, , 53'3--;'7&-:5:5 Phone Zip o Addition 0 Alteration 0 Repair 0 Replacement /V<-/'''W /-# adj' PLUMBING PERMIT FEES Water Tap Fee - %" $150.00 Water Tap Fee - 1" $200.00 X Water Tap Fee - 1~" $250.00 Water Tap Fee - 2" $300.00 Current License on File Comment: Total c9 i!i 0 ' &' es 0 No 0 N/A WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT I Approved By: g. ?Jf~~pJ I Rev. 2008-10 ELECTRICAL PERMIfNNpP'irdiTloN 132 t>8 Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 C'. Mail Address ~11Cl(!L 2. i,/ .h./ ~e~e ? 0. <3~ t13;( ~i/1at1 Alt tl,9t~~g 3. Class of Work: .!g NEW RESIDENTIAL 0 NEW COMMERCIAL 0 REMODELING/ADDITIONS 0 UPGRADE SERVICE Describe Work: ()'. 4. Jm U~/j 1/..,/ 5.Current License on File Yes 0 No 0 N/A Application Date: q ~ (9 ~ a c; Job Address Service Fee = (Amp Fee + $5.00 per branch circuit) 1-100 Amp Fee...... ...... ...... .. ...$25.00 101-200 Amp Fee.................... ...$35.00 201-300 Amp Fee... ... ... ...... ..... ...$55.00 301-400 Amp Fee... ... ... ............ ..$75.00 401-500 Amp Fee..................... ..$95.00 501-600 Amp Fee.................... .$115.00 601-700 Amp Fee.....................$135.00 701-800 Amp Fee...... ...... ...... .. .$155.00 801-900 Amp Fee.................... .$175.00 901-1000 Amp....................... ..$195.00 IF OVER 1000 Amp 1st 1000 Amp Fee.............. ....$195.00 Each additional 100 Amps.........$20.00 Notice I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws 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 authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. ~. ~ /() /o.-{J7 Date E 3141 Permit Fee: $ / / if. Crt Phone f. ELECTRICAL PERMIT FEES Upgrade Existing Service............ .$25.00 Temporary Service.................... $15.00 /5 .60 Fire Alarm System................. ....$15.00 Signs (each)... .. .... .. .. ... .. .... .. ......$25.00 Miscellaneous Apparatus......... .....$15.00 CommerciallMulti Family and All Upgrades: # of Circuits x $5.00 Amp Fee Amp Fee + Circuit Total New Residential: (Finished Area) Single/Two Family Dwellings -' I q D sq. ft. x .063 Modular/Manufactured Homes...... .$50.00 Other: (alterations, additions and modifications) 7 L/. q ? Receptac1es/SwitcheslLighting Fixtures (110 volt only) # of Apparatus .......... x $1. 00 Power Apparatus (220 Volt or higher) # of Apparatus....... x $8.00 Smoke Detectors..... x $3.00 Permit Issuance Fee................. ..$25.00 C?\"'s' Cl c) ,i'1(7 I.,. Total Comment: WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT I Approved By: ~~ ~.I- ~ Rev. 2008-10 PLuMBINatfEIllVIit l~1>LICATION ( 3:Jof) P 2047 00 Permit Fee: $ 13 0 - ~ Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 Application Date: ?,,)')-()~ {(~d~ Mail Address (})) . ~~ It- 1011f oo.it IJ ~ Zip ~ Job Address Comments: Notice I hereby certify that I have read and examined this application and know the same to be true and correct All provisions oflaws 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 authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. ? '1---v-v0 r of Contractor or Authorized Agent f-3/-oc Date Phons J3-.J~~3 Phone w 0 Addition 0 Alteration 0 Repair 0 Replacement .~ PLUMBING PERMIT FEES Modular Home... ................. ..$50.00 Type of Fixture No. Kitchen........................... ...$12.00 x Bath.....ResidentiaVSingle Stall $12.00 x_ ......... ........ ...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 Outside Water Faucet...................$6.00 x Drinking Fountain........................$6.00 x_ Backflow/Grease Trap............ .$15.00 Water Service..................... ..$15.00 Sewer. .. . . . . . . .. . .. . .. . . .. . . . . . .. . . ... $15 . 00 Groundwork..................... ....$15.00 Septic Tank & Laterals.... ........ $15.00 Lawn Sprinkler System............$10.00 Sprinkler System (Commercia1)..$30.00 Gas/Water Piping System (Commercial)............... ..... ....$50.00 Permit Issuance Fee................ .$25.00 Current License on File Comment: Total DYes 0 No 0 N/A IJ-uo I )~U0 ~~ d~ ~-<.\0 I 0" d0 l d-- t dv I'~' ("I S .' V'-" l!.-- JJ IS-, J-:) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT I Approved By: . (1] vI ~~ Rev. 2008-10 CITY OF BLAIR HOMEOWNER VERIFICATION FOR PLUMBING AND/OR MECHANICAL PERMITS R IT IT A VA) ,5 NI OGi< Print your full name on line above: , states the following: 1. I am the owner of the single family dwelling for which I am applying for a plumbing and/or mechanical permit. Address: r.J.2:J. C)v~"J 2. I am applying for a plumbing and/or mechanical permit for a single family dwelling and it is or will be my principal residence. 3. I will install and connect the plumbing and/or mechanical by myself, without compensation or pay from or to, any other person. 4. I have sufficient knowledge of the 2006 International Code requirements to make an electrically safe and mechanically secure installation, which will meet the minimum standards referenced in the 2006 International Code. 5. I am aware of all inspections required prior to a final. 6. I will call twenty-four (24) hours in advance for an inspection. I am also aware that it is not the inspector's job or duty to be my instructor in plumbing and/or mechanical. 7. I am aware that violation of the code makes it a Class 1 misdemeanor to make a false statement on a request for inspection. 8. By signing this form I am stating the above information is true an correct. ~~-J~ f-3/-o '7 Date (5)- EQU.ll..t10USUlG 218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-maii cilyofblair@cLblair,ne.us """""" ~L^ffi BUILDING INSPECTION REPORT o WASHINGTON COUNTY o OTHER LOCATION OF INSPECTION' NAME OF OWNER- CONTRACTOR' DATE INSPECTION REQUESTED' TIME INSPECTION REQUESTED- PERMIT NO' TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL D FINAL 0 PARTIAL D STATUS CHECK COMMENTS: UTILITIES: 0 SEWERTAP 0 SEWER D SEPTIC 0 WATERTAP D REMOTE 0 WATER SERVICE o PARTIAL COMMENTS: ELECTRICAL: D ROUGH IN D FINAL 0 PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL PASSED FAILED o D COMMENTS: MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE D RADIANT HEAT D FINAL D PARTIAL PASSED FAILED o D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PRESSURE TEST PASSED FAILED o D PARTIAL PASSED FAILED D D COMMENTS: -" /to Co/iee te INSPECTOR' ~IiO f{(~ DATE OF INSPECTION MADE: ~o_ ();;,~t0:7 TIMF' I, 33 , FAXED OPPD\BURTREA TO CONNECT SERVICE: ON BY J" I V ! ! r"' .,./ "'" _, /" >- ~IC(ju'Lj~J REPORTT L_3~o8 . ESR-1385* Issued September 1, 2004 This report is subject to re-examination in one year. ICC Evaluation Service, Inc. www.icc-es.org BusinesslRegional Office .. 5360 Workman Mill Road, Whittier, CalifOmia 90601 .. (562) 699-0543 Regional Office .. 900 Montclair Road, Suite A, Birmingham, Alabama 35213 .. (205) 599-9800 Regional Office .. 4051 West Flossmoor Road, Countly Qub Hills, Illinois 60478 .. (708) 799-2305 DIVISION: 03-CONCRETE Section: 03151-Concrete Anchoring S i Lt.- P t.a...(.;;,. ~o,--t.}. C py REPORT HOLDER: FI HIL TI, INC. 5400 SOUTH 122ND EAST AVENUE TULSA, OKLAHOMA 74146 (800) 879-800lADDRESS J.::J-:3- ';::r A,'" (< So iJ EVALUATION SUBJECT: KWIK BOLT 3 CONCRETE AND MASONRY ANCHORS 1.0 EVALUATION SCOPE Compliance with the following codes: III 2000 International Building Code@ (IBC) III 2000 International Residential Code@ (IRC) III 2002 Accumulative Supplement to the International Codes TM III 1997 Uniform Building Code™ (UBC) Properties evaluated: Structural 2.0 USES '3 - S- -0 ,c. f) {(. /i.~.) ,9...1 ';' I are zinc and 19 with a t 153. T stainle stainle and hI stainle r::j"e ~ T {,.( a......l;c~ The /l7tt//'~ threaded at one t:llld, The standard KWIK DUll v Ila", ~ .." ___ length equal to or less than three bolt diameters, while the Long Thread Kwik Bolt 3 has a thread length greater than three bolt diameters, The tapered mandrel has an increasing diameter toward the anchor base, and is enclosed by a three-section wedge that freely moves around the mandrel. In the vertical direction, the wedge movement is restrained by the mandrel taper at the bottom and by a collar at the top of the mandrel. When the anchor nut is tightened, the wedge is forced against the wall of the predrilled hole to provide anchorage, leter(12.7,15.9, )rs are available ng with ASTM A 9 304 and 316 also made from I stainless steel, nchors use 316 ~ fi-C'1..$C- pJ'{' (tJ ".,. ~ JA_Ct'<"'S'CI,j 4.0 DESIGN AND INSTALLATION 4.1 Design: Minimum embedment depth, edge distance, and spacing requirements are set forth in Tables 1 and 2, Allowable stress design tension and shear loads are as noted in Tables 3 through 14. Tables 4, 7, 8, 9, and 10 also apply to Kwik Bolt 3 anchors installed in holes drilled with Hilti Matched- Tolerance Diamond Core Bits as noted in the footnotes to each table. Allowable loads for Kwik Bolt 3 anchors subjected to combined shear and tension forces are determined by the following equation: (P jPt)5/3 + (V jVt)5/3 5, 1 The Kwik Bolt 3 (KB3) Concrete and Masonry Anchor is used to resist static and transient seismic and wind tension and shear loads in uncracked, normal-weight concrete, structural lightweight concrete, structural lightweight concrete over where: metal deck, and grout-filled concrete masonry. The anchor Ps = Applied service tension load (Ibf or N), system is an alternative to cast-in-place anchors described in Sections 1912 and 2107 of the IBC and Sections 1923,1 and Pt = Allowable service tension load (Ibf or N). 2107,1.5 of the UBC. The anchor systems may also be used where an engineered design is submitted in accordance with Vs = Applied service shear load (Ibf or N). Section R301.1.2 of the IRe. Vt = Allowable service shear load (Ibf or N), 3.0 DESCRIPTION 4.2 Installation Requirements: The Kwik Bolt 3 expansion anchors consist of a stud, wedge, Kwik Bolt 3 shall be installed in holes drilled into the base nut, and washer. The stud is manufactured from carbon or material using carbide-tipped masonry drill bits complying stainless steel material. The carbon steel Kwik Bolt 3 anchors with ANSI B212.15-1994 or where permitted by the tables, have a 5 IJm (0,0002 inch) zinc plating, The anchor is Hilti Matched-Tolerance Diamond Core Bits. The nominal drill illustrated in Figure 1 of this report. bit diameter shall be equal to that of the anchor. The drilled The wedges for the carbon steel anchors are made from hole shall exceed the depth of anchor embedment by at least carbon steel, except for aIl1/4-inch (6.4 mm) lengths and the one anchor diameter to permit over-driving of anchors and to 3/4-inch-by-12-inch, 1-inch-by-6-inch, 1-inch-by-9-inch and 1- provide a dust collection area. The anchor shall be hammered inch-by-12-inch (19.1 mm by 305 mm, 25 mm by 152 mm, 25 into the pre'drilled hole until at least six threads are below the mm by 229 mm, and 25 mm by 305 mm) sizes, which have fixture surface. The nut shall be tightened against the washer AISI316 stainless steel wedges. All carbon steel components until the torque values specified in Table 1 are attained. *Revised August 1, 2005 E$ REPORTS'" are not to be construed as representing aesthetics or any other a/tributes not specifically addressed, nor are they to be construed os an endorsement of the subject of the report or a recommendation for its lise. There is no warranty by ICe Evaluation Service, Inc., express or implied, as to any finding or other matter in this report, or as to any product covered by the report. Copyright @ 2004 Page 1 of9 a-~R LOCATION OF INSPECTION' BUILDING INSPECTION REPORT o WASHINGTON COUNTY o OTHER NAME OF OWNER CONTRACTOR' DATE INSPECTION REQUESTED' TIME INSPECTION REQUESTED' PERMIT NO' TYPE OF INSPECTION REQUESTED: BUILDING: FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 o STATUS CHECK COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED PASSED FAILED o 0 NOTES/REMARKS' INSPECTOR' DATE OF INSPECTION MADE: TIME' FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY Page 2 of9 ESR-1385 4.3 Special Inspection: Special inspection shall be provided in accordance with Section 1704 of the IBC or Section 1701 of the UBC when design loads are based on special inspections being provided during anchor installation, as setforth in Tables 3 through 14. Special inspection in accordance with Section 1704 of the IBC shall be provided under the IRC when special inspection is specified in. Tables 3 through 14. The code official shall receive a report, from an approved special inspector, that includes the following details: 1, Anchor description, including the anchor product name, nominal anchor and bolt diameters, and anchor length. 2, Hole description, including verification of drill bit compliance with ANSI B212.15-1994 or the Hilti specification for matched tolerance diamond core bits, hole depth, and cleanliness, 3, Installation description, including verification of concrete compressive strength by ASTM C 42 methods, and verification of anchor installation and location (spacing and edge distance) in accordance with Hilti's published installation instructions and this report. 5.0 CONDITIONS OF USE The Kwik Bolt 3 Concrete and Masonry Anchors described in this report comply with, or are suitable alternatives to what is specified in, those codes listed in Section 1.0 of this report, subject to the following conditions: 5.1 Anchor sizes, dimensions, and installation shall comply with this report and Hilti's published installation instructions. 5.2 Allowable tension and shear loads shall be as noted in Tables 3 through 14 of this report, 5.3 Calculations and details demonstrating compliance with this report shall be submitted to the code official for approval. 5.4 The use of anchors shall be limited to installation in uncracked, normal-weight concrete, structural lightweight concrete, structural lightweight concrete over steel deck, and uncracked grout filled masonry concrete, Cracking occurs when ~ > fr due to service loads or deformations. 5.5 When using the basic load combinations in accordance with IBC Section 1605,3.1 or UBC Section 1612.3.1, allowable loads are not permitted to be increased for wind or earthquake loading. When using the alternative basic load combinations in IBC Section 1605,3.2 or UBC Section 1612.3.2 that include wind or seismic loads, the allowable shear and tension loads for anchors are permitted to be increased by 33'/3 percent. Alternatively, the basic load combinations may be reduced by a factor of 0.75 when using IBC Section 1605.3.2. 5.6 Anchors are not permitted for use in conjunction with fire-resistance-rated construction. Exceptions would be: . Anchors resist wind or seismic loading only. . For other than wind or seismic loading, special consideration is given to fire exposure conditions, 5.7 Use of carbon steel Kwik Bolt 3 anchors shall be limited to dry, interior locations. Hot-dipped galvanized and stainless steel Kwik Bolt 3 anchors are permitted in exterior exposure or damp environments. 5.8 Since an ICC-ES acceptance criteria for evaluating data to determine the performance of expansion anchors subjected to fatigue or shock loading is unavailable at this time, the use of these anchors under these conditions is beyond the scope of this report. 5.9 Special inspection shall be provided in accordance with Section 4.3 of this report when required by Tables 3 through 14, 5.10 Anchors shall be manufactured by Hilti, Inc., Feldkircherstrasse 100, Schaan, Liechtenstein, under a quality control program with inspections conducted by Underwriters Laboratories Inc. (AA-668). 6.0 EVIDENCE SUBMITTED 6.1 Data in accordance with the ICC-ES Acceptance Criteria for Expansion Anchors in Concrete and Masonry Elements (AC01), dated April 2002, including seismic tests, reduced spacing tests and reduced edge distance tests, 6.2 Quality control manuals, 7.0 IDENTIFICATION The anchors shall be identified in the field by dimensional characteristics and packaging. The packaging label indicates the manufacturer's name (Hilti, Inc.) and address, the size and type of anchor, the name of the inspection agency (Underwriters Laboratories Inc.), and the ICC-ES report number (ESR-1385). A length identification code letter is stamped on the threaded end of the bolt. The length identification system is described in Table 15, TABLE 1-INSTALLATION SPECIFICATIONS' SETTING DETAILS ANCHOR SIZE '/4 inch 3/8 inch '/2 inch 5/8 inch 3/4 inch 1 inch Drill bit size = anchor diameter (inches) '/. % '/2 5/8 3/. 1 Wedge clearance hole (inches) 5/'6 7/'6 9/'6 "/'6 ,3/,6 1'/8 Anchor length (min./max,) (inches) 1'/. I 4'/2 2'/8 I 7 23/. I 7 3'/2 I 10 6 I 12 6 I 12 Thread length std./long thread length (inches) 3/. I 3 7/8 I 55/8 1'/. T 43/. 1'/2 T 7 1'12 I 6 2'/. I 6 Installation: Stainless steel 6 20 40 85 150 200 Torque guide Carbon steel: Min, embedment 4 20 40 85 150 200 values 1 (ft-Ibf) in Carbon steel: Std, embedment 4 20 40 85 150 325 concrete Installation: Torque guide values Carbon steel: Min, Embedment 4 15 25 65 120 - (ft-Ib) in Carbon steel: Std, Embedment 4 15 25 65 120 - concrete masonry Min, base material thickness (inches) 3 inches or 1.5 x embedment depth, whichever is greater For SI: 1 inch = 25.4 mm, 1 ft-Ibf = 1,356 N-m. 'Installation torques are applicable for all anchors installations unless noted otherwise in this report, BUILDING INSPECTION REPORT CITY OF BLAIR o WASHINGTON COUNTY o OTHER LOCATION OF INSPECTION' NAME OF OWNER' CONTRACTOR' DATE INSPECTION REQUESTED' TIME INSPECTION REQUESTED' PERMIT NO' TYPE OF INSPECTION REQUESTED: BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL o STATUS CHECK COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 AJC 0 FURNACE 0 RADlANTHEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: PASSED FAILED o 0 o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' Secf)6P1 <3t/C)[/ e>F- -Me ~6 Xl? c: iJ1lVt>& SfmcnuAt:'S c:.~V~~ I C~j/}..f~/4ce... ,)-f1u~f~~~ e CA.r/rd.' ~ ~' 1/ ~ i. t<Jlfl.4e r: ' -., '-'''~- ~oft!:r;r /lJ"t<J 0':rrtl.tlul'~..s. 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" rn '5 0- :;; ~C\i ~" roD " '" ~~ f " "0 Ul ~~-g ,,- ltl ~ ~ ~ ~~ ~ {g~"'Q; ~~-a ~~ ~ ~E~ gE-5 "'''0 " -" ~ '" -" '" ~ ffi ~ ~.E:m ""0,,, ~~ .~ -g~~ ro Q)';:: E~ ~ .~ ~.~ .~ ~ ~ ltl " <:: >-.r: " ltl " 1E"O Q) ~ ~ -"",0- ~ro ;g '0 ~ E ~.~ ~ B ~~ ""0 '" <:: <:: '" ltl ltl <:: "'C Q).2 :~~ 0)", " -g:o~ &~S ~ "m CITY or 5LAII.:2 BUILDING PERMIT SUPPORTING DOCUMENTS This building permit packet includes various items dealing with particular code requirements and/or building 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 packet is only designed and distributed to aid you in your building 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. ~ ~- . 1 ,. ,k" ~./tt- Own - ccupant Contractor t2 ( ) J2 ! ,; , \ /!.-Jll1L/t,,--_ {U~{I ,L-... City of Blair ,S-lC;~<l Date EQUAllIOUSmo 218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci.blair,ne.us "''''''''' Page 5 of 9 ESR-1385 TABLE 6 - CARBON STEEL KWIK BOLT 3 ALLOWABLE TENSION AND SHEAR VALUES (in pounds), STRUCTURAL LIGHTWEIGHT CONCRETE Yc = 2,000 psi Yc = 3,000 psi Yc = 4,000 psi Anchor Anchor Tension Tension Tension 5hear4 diameter depth With 5p. Without (inch) (inches) Insp.3 5p. Insp. Insp.3 5p. Insp. Insp.3 5p. Insp. 1/4 1 1/8 275 138 337 169 399 200 397 2 594 297 665 333 737 368 397 3/8 15/8 586 293 686 343 787 393 889 21/2 1119 560 1339 670 1560 780 1255 1/2 21/4 1049 524 1284 642 1519 759 1745 31/2 1810 905 2048 1024 2286 1143 1867 5/8 23/4 1560 780 1815 908 2071 1035 2578 4 2483 1242 2828 1414 3172 1586 3151 3/4 31/4 1922 961 2242 1121 2562 1281 3834 43/4 3037 1519 3996 1998 4955 2477 4701 For 51: 1 inch = 25,4 mm, 1 psi = 6,9 kPa, 1 Ib = 4,45 N, 1The tabulated tension values are for anchors installed in structural sand-lightweight concrete having the minimum indicated compressive strength at the time of installation. Concrete aggregate shall comply with ASTM C 330, These loads may be interpolated for concrete strengths and embedments between the tabulated values. 2Allowable loads or applied loads may be modified in accordance with Section 5,5 of this report due to short-term wind or seismic loads. :>rhese tension values are only applicable when anchors are installed with special inspection in accordance with Section 4,3 of this report. "The tabulated shear values are for anchors installed in structural sand-lightweight concrete having minimum 2,000 psi compressive strength at the time of anchor installation. The concrete aggregate shall comply with ASTM C 330. These loads may be interpolated for concrete strengths and embedments between tabulated values, TABLE 7 - STAINLESS STEEL KWIK BOLT 3 ALLOWABLE TENSION AND SHEAR VALUES (in pounds), STRUCTURAL LIGHTWEIGHT CONCRETE1,2 Yc - 2,000 psi Yc = 3,000 psi Yc = 4,000 psi Anchor Anchor Tension Tension Tension 5hear4 diameter depth With 5p. (inch) (inches) Insp.3 5p, Insp. Insp.3 5p. Insp. Insp.3 5p. Insp. 1/4 11/8 245 122 301 150 357 179 547 2 509 254 584 292 660 330 599 3/8 15/8 562 281 623 311 684 342 825 21/2 920 460 1198 599 1476 738 1258 1/25 21/4 951 475 1155 578 1359 680 1757 31/2 1354 677 1853 926 2351 1176 2702 5/85 23/4 1471 736 1607 804 1744 872 2697 4 2301 1151 2717 1358 3132 1566 4219 For 51: 1 inch = 25,4 mm, 1 psi = 6.9 kPa, 1 Ib = 4,45 N, 1The tabulated tension values are for anchors installed in structural sand-lightweight concrete having the minimum indicated compressive strength at the time of installation. Concrete aggregate must comply with ASTM C 330. These loads may be interpolated for concrete strengths and embedments between the tabulated values, 2Allowable loads or applied loads may be modified in accordance with Section 5,5 of this report due to short-term wind or seismic loads, :>rhese tension values are only applicable when anchors are installed with special inspection in accordance with Section 4,3 of this report, "The tabulated shear values are for anchors installed in structural sand-lightweight concrete having minimum 2,000 psi compressive strength at the time of anchor installation, The concrete aggregate shall comply with ASTM C 330. These loads may be interpolated for concrete strengths and embedments between tabulated values. 5The 1/2 and 5/8 inch diameter anchors are permitted to be installed in a Hilti matched-tolerance diamond cored hole, 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. A $50.00 refundable deposit is being collected for all misc. permits. 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. (l Q ~ .Un^L/f",L ctor/Owner Contractor/Owner /~ lJLl!~~ CitY of Blair (-~ S-l,~~oV Date Page 6 of 9 ESR-1385 TABLE 8 - CARBON STEEL KWIK BOLT 3 ALLOWABLE TENSION AND SHEAR VALUES FOR ANCHORS INSTALLED IN HIL TI MATCHED-TOLERANCE DIAMOND CORED HOLES IN NORMAL-WEIGHT CONCRETE (in pounds)1.2 rc = 2,000 psi rc = 3,000 psi rc = 4,000 psi rc = 6,000 psi Anchor Anchor Tension Shear Tension Shear Tension Shear Tension Shear diameter depth With Sp. Without WrthSp. Without With Sp, Without WithSp. Without (inch) (inches) Insp.3 Sp. Insp. Insp,3 Sp. Insp. Insp.3 Sp. Insp, Insp.' Sp. Insp. 21/4 1049 524 1745 1284 842 2143 1519 759 2541 1853 927 2717 1/2 31/2 1810 905 1832 2048 1024 2186 2286 1143 2541 3035 1518 2717 43/4 2000 1000 1832 2207 1103 2186 2414 1207 2541 3083 1541 2717 23/4 1766 883 2578 1898 949 3198 2029 1015 3817 2601 1300 3988 5/8 4 2469 1235 3324 2805 1402 3571 3141 1570 3817 3825 1912 3988 51/2 3079 1539 3324 3462 1731 3571 3846 1923 3817 4992 2496 3988 31/4 1873 936 3834 2143 1071 4593 2412 1206 5353 3340 1670 5353 3/4 43/4 2889 1445 4701 3802 1901 5579 4714 2357 8456 5491 2745 8456 61/2 4011 2005 4701 5160 2580 5579 6309 3155 8456 6309 3155 6456 41/2 2816 1408 6625 3508 1754 7125 4204 2102 7625 4190 2095 8625 1 6 3834 1917 8625 5103 2551 8625 6367 3183 8625 7568 3784 8625 9 5804 2902 8625 6775 3388 8625 7741 3870 8625 9610 4805 8625 For SI: 1 inch = 25.4 mm, 1 psi = 6.9 kPa, 1 Ib = 4.45 N. 'The tabulated tension and shear values are for Kwik Bolt 3 installed in stone ag9regate concrete having the minimum tabulated compressive strength at the time of installation, Concrete aggregate shall comply with ASTM C 33. These loads may be linearly interpolated for concrete strengths and embedments between tabulated values, 2Allowable loads or applied loads may be modified in accordance with Section 5.5 of this report due to short-term wind or seismic loads, 3These tension values are only applicable when anchors are installed with special inspection as set forth in Section 4.3 of this Report, TABLE 9 - STAINLESS STEEL KWIK BOLT 3 ALLOWABLE TENSION AND SHEAR VALUES VALUES FOR ANCHORS INSTALLED IN HILTI MATCHED-TOLERANCE DIAMOND CORED HOLES IN NORMAL-WEIGHT CONCRETE (in pounds)1,2 rc = 2,000 psi rc = 3,000 psi rc = 4,000 psi rc = 6,000 psi Anchor Anchor Tension Shear Tension Shear Tension Shear Tension Shear diameter depth With Sp. Without With Sp, Without WithSp, Without With Sp. Without (inch) (inches) Insp.' Sp, Insp, Insp.3 Sp. Insp. Insp.' Sp. Insp. Insp.' Sp. Insp. 21/4 922 461 1757 1120 560 1995 1318 659 2233 1474 737 2571 1/2 31/2 1313 657 2702 1800 900 2702 2288 1144 2702 2413 1207 2702 43/4 1809 905 2702 2045 1023 2702 2281 1140 2702 2716 1358 2702 23/4 1470 735 2697 1584 782 3269 1657 829 3840 2082 1041 4283 5/8 4 2210 1105 4283 2609 1304 4283 3008 1504 4283 3959 1979 4283 51/2 3163 1581 4283 3531 1766 4283 3900 1950 4283 5337 2668 4283 31/4 1393 697 2700 1754 877 2700 2114 1057 2700 2354 1177 2700 3/4 43/4 2258 1129 4225 2873 1437 4225 3484 1742 4225 4204 2102 4225 8 2843 1321 4500 3364 1682 4500 4084 2042 4500 4613 2306 4500 41/2 2210 1105 5700 2739 1369 6350 3267 1634 7000 4325 2162 7000 1 6 3594 1797 7000 4738 2369 7000 5881 2941 7000 6607 3303 7000 9 5045 2523 7000 6751 3376 7000 8457 4228 7000 8457 4228 7000 For 51: 1 inch = 25.4 mm, 1 psi = 6,9 kPa, 1lb = 4.45 N, , See Table 8 for footnotes, TABLE 10 - CARBON STEEL KWIK BOLT 3 ALLOWABLE TENSION AND SHEAR VALUES FOR ANCHORS INSTALLED IN HILTI MATCHED-TOLERANCE DIAMOND CORED HOLES (in pounds), IN STRUCTURAL LIGHTWEIGHT CONCRETE1,2 rc = 2,000 psi rc = 3,000 psi rc = 4,000 psi Anchor Anchor Tension Tension Tension Shear' diameter depth WithSp. Without With Sp. Without With Sp. Without (inch) , (inches) Insp.' Sp. Insp, Insp. 3 Sp. Insp. Insp.' 5p. Insp. 1/2 21/4 1049 524 1284 842 1519 759 1745 31/2 1810 905 2048 1024 2286 1143 1867 5/8 23/4 1560 780 1815 908 2071 1035 2578 4 2483 1242 2828 1414 3172 1586 3151 3/4 31/4 1847 924 2154 1077 2462 1231 3834 43/4 2919 1459 3840 1920 4761 2381 4701 For SI: 1 inch = 25.4 mm, 1 psi = 6.9 kPa, 1lb = 4.45 N. 'The tabulated tension values are for anchors installed in structural sand-lightwei9ht concrete having the minimum tabulated compressive strength at the time of installation, Concrete aggregate shall comply with ASTM C 330. These loads may be linearly interpolated for concrete strengths and embedments between tabulated values, 2Allowable loads or applied loads may be modified in accordance with Section 5,5 of this report due to short-term wind or seismic loads. 3These tension values are only applicable when anchors are installed with special inspection in accordance with Section 4.3 of this report, 'The tabulated shear values are for anchors installed in structural sand. lightweight concrete having a minimum 2,000 psi compressive strength at the time of installation, The concrete aggregate shall comply with ASTM C 330, Linear interpolation may be used for concrete strenghts and embedment depths between those listed. '"~ ~ Page 7 of 9 ESR.1385 TABLE 11 - ALLOWABLE TENSION AND SHEAR VALUES FOR HIL TI KWIK BOLT 3 CARBON STEEL ANCHORS INSTALLED IN THE FACE SHELLS OF GROUT-FILLED CONCRETE MASONRY WALLS (in pounds)""'" ANCHOR EMBEDMENT MIN. DISTANCE TENSION SHEAR DIAMETER DEPTH' FROM EDGE OF UBC WHh Sp. UBC Without Sp. IBCIIRC. IBCIIRC. (Inches) (inches) WALL6 (inches) Insp. 7 Insp, UBC 4 152 76 121 380 304 11/8 12 152 76 121 380 304 1/4 427 4 540 270 432 342 2 12 540 270 432 427 342 4 321 161 257 736 589 15/8 12 342 171 273 938 751 3/8 4 782 391 626 955 764 21/2 12 782 391 626 1317 1054 21/4 4 628 314 502 830 664 12 667 333 533 1464 1171 1/2 4 905 452 724 1051 840 31/2 12 905 452 724 2317 1853 23/4 4 814 407 651 888 710 5/8 12 866 433 692 2165 1732 4 4 1242 621 994 929 743 12 1294 647 1035 2654 2123 31/4 4 1036 518 829 784 627 12 1036 518 829 3135 2508 3/4 4 1645 823 1316 821 657 43/8 12 1711 855 1368 3283 2627 For SI: 1 Inch = 25.4 mm, 1 Ib=4.45 N 'Values valid for anchors installed in face shells of Type 1. Grade N, lightweight. medium-weight. or nonnal-weight concrete masonry units conforming to ASTM C 90 or UBC Standard 21-4, The masonry units shall be fully grouted with coarse groutconfonning to IBC 2103,10 and ASTM C 476 or UBC Section 2103.4 and UBC Standard 21-19. Mortar shall comply with IBC Section 2103.7 and ASTM C 270 or UBC Section 2103,3 and UBC Standard 21-15, Type S, N, or M, Masonry prism strength shall be at least 1,500 psi at the time of anchor installation when tested in accordance with IBC Section 2105.2.2,2 and ASTM C 1314 or UBC Section 2105,3.2 and UBC Standard 21-17. 'Anchors shall be installed a minimum of 1-3/8 inch from any vertical mortar joint in accordance with Figure 2. 'Anchor locations are IimHed to one per masonry cell with a minimum spacing of 8 inches on center, 4A1lowable loads or applied loads may be modified in accordance with Section 5,5 of this report due to short-tenn wind or seismic loads. 'Embedment depth shall be measured from the outside face of the concrete masonry unit. 6For intennediate edge distances. allowable loads may be detennined by Iinearty interpolating between the allowable loads at the two tabulated edge distances, 7These tension values are only applicable when anchors are installed with special inspection in accordance with Section 4.3 of this report. .Special inspection shall comply with Section 1704,5 of the IBC for anchorages in masonry. WASHINGTON COUNTY ASSESSOR'S OFFICE mmillnllllillllillmIliIIIll1IIlIlIIillan Residential Property Record Card - lerr~~Inc. Condition 'IAverage Type (Single-Family ,Quality lAverage !ArCh-:-Typel ~fvVaiiT-==~1I00% VINYL t:f. ~all 2 ^~J Data Provided By: COUNTY BOARD OF EQUAUZATION County Assessor. Printed on 08/0212007 at 12:04:1~_~__~__.~..____ ~ , ~__ ~_,__ ~i;@::C'~grnr Hi~Kiif.9.rM~l(&n;~~H'ilffifr~~Th;:;JfJ\WgjIi'&i0 ,eIB.!:!.'E_~!:!!__. 890043981 Current Owner JENSEN, LENA L i 'h.dP N!:!m'!~.r_^,_^_JBC - - - 42- 3 I i5i{~~_..~__~________12029 WASHINGTON ST BLA ~ddress -,PO BOX 103 I~Hal_,_..,..__.___,^_...JBC LOT 3 BLK 42 113 PC 10 19..~ Sf. Zi~JWACO, NE 68460-0000 - 'ICadastral # r~eig~b~rh()E~___._!~~~~1~~~i*,~rl~~~ijjl~J~~\'Iif1f'{!:~~:~~t~1~~f[qpfff7Plii' ILot Width 160 IStreet I ILot Depth JI00 IUtilities I IUnits/Lots' l~menitie.~_L~--..I (yalue Method SF Amenities 2 L-. _ of Units _ Wnit Value ~djustmenL_____ Lot Value 6000 j2.35 /Foundation !Slab Area !Crawl Area IBasement Area IMin Finish IRec Finish art Finish I I I I I I 1- l!:!~~ 7 lBedrooms ; 2 [Bathrooms' .. 11 l~arn~eT~~Detached IGarage Area i 4 8 4 I --j INO. of Stalls I ~gdfn~~lt%~ 1920 580 Actual Age 87 4,115 (Remodel Year--' t.:.:.:::=___, 2, 930!Remodel Type I IEffectiveAge --~34 rPh~p~"-' '40% !Functional Depr. (Economic DepJ=: fTotal Depreciation 40% t- - I i 1 i 11142 I i I I I \f1~,~g:~'K.i\liii~~iWml\\r""'$.~"l'!~J--~ 1~}i~:i~~ua~~~~-O@!isT-"-~-"---~--t 1:; ~~~ I i~l~~~1ii:;~ous'mprovements~---i 11~: :~~ I ~:[~~~e~iii~~!T1entcos-t-New------1 1~~: : ~ ~ I Les_s Depreciation ,-----J (54,325) I ~:~~~!e7r~~.~~~ew_~~~~_,_~.___"J 8 0, 2151 ~~"!e SU"!.~________'m."______...._J Estir.nat.e ofValue,,________ ! 94,315 Value Per Square Foot l 67.00 ~~~jry?f~~tffi[1::[f,9tlli99mB~mfIJ~1~!~~iA!t~J~1 c" Adjustment Model I NAi Price I 1,1901' ~ct~ I I ~djuSted .~! ! 08!~~;?[~lr;f;l~~~jY~41tli~~t:4.~11~~~~t!;\.I&;;,~ific Vlodel Number I -----------~-- Description: NA ' ~alcuiatjon----------------l NA Ja'li"e---------..-----------l NA *DATA"USEO-FClRCOSTCALCULATI-ONS SUPPLIED BY MARSHALL -&-SWIFT-~hi7;h-he;,~by-~~;;rves IPATIO i CONCRETE DRIVE ISLAB W/ROOF & STEPS I i I [ I f- ~ '0' 1---------.-....-, 16 28 PATIO @ 17 r:l 22LJ 1 Sl/ll< @> 12 50 ORMWAY1Q3SSQ FT 2~ 1 SIlO. @ 10 N ~~~"~"_.~.- ,~,~,--^W_.._~_~~_T__--.-_j all right herein, ~.---'~---,--~-~~-........~= Page 9 of9 ESR-1385 Mandrel Area Nut Anchor Installation is Restricted to Non-Shaded Areas Washer /' " Thread Area , (" . ( ; Anchor Body /' / /' Mortar Joint ,-318' Concrete Masonry Unit (Grouted) Triple Segmented Wedge 1-3/8~ FIGURE 1-KWIK SOL T 3 :., g FIGURE 2-ACCEPTANCE LOCATIONS (NON-SHADED AREAS) FOR HIL TI KWIK SOL T 3 ANCHORS IN GROUT.FILLED CONCRETE MASONRY WALLS ~ I '" ;i 31 - M1N.4"- MAX. ," OFFSET, lYP. FIGURE 3 - INSTALLATION IN THE SOFFIT OF CONCRETE OVER METAL DECK FLOOR AND ROOF ASSEMBLIES E = DEPTH OF EMBEDMENT FIGURE 3-PROFILE OF STRUCTURAL LIGHTWEIGHT CONCRETE OVER METAL DECK m :.:::-) eX Ooq O.;J,d{ 15 WASHINGTON COUNTY, STATE OF NEBRASKA RECORDED rrzi(.lf ~tJ/ ;{{J()~Kf /:51 FM. BOOK 539 PAGE(S) lOgs Z009MAY 20 PM I: 57 J\ctAUVa...fhtad4bnJ SIDEWALK WAIVER KARE[\j ,I:!" MADSEN WASHiNGTON COUNTY REGISTER OF DEEDS IiEGISTER OF DEEDS The undersigned being the owners ofthe following described real estate, to_wit:8L,ll, IR, NE 108 5 b:'~ ft C~' V B L. ~~:, [) Lot 35 l W el mers A-cid.i -t\ Of'\ B\Q\r I 'NClsh\'fl~i<lf\ .c.ouf\'kj (2.'2.2 Sa&cf\ S"'\-.) hereby aclmowledge that they have made an application to the City of Blair for the waiver of the requirement for the construction of sidewalks in conjunction with the construction of a residence thereon. Said owners further hereby specifically agree that said..waiver is not a permanent waiver, and that at any time the City of Blair requests or requires that a sidewalk be constructed on such real estate, the owners hereby agree that they will, within a reasonable time, construct such sidewalk or participate in a sidewalk improvement district if same is created by the City of Blair. The owners hereby specifically agree that this agreement shall constitute a covenant which shall run with the land, and that upon thefiling of this agreement against the real estate described hereinabove, all successors, assigns, or transferees shall be bound by the tenus and conditions ofthis agreement as though an original party hereto. This agreement shall be binding upon the heirs, personal representatives, successors, and assigns ofthe undersigned. Dated: iJ'Lil./ A J ",C; d~ LJ , 20 fl1. Recorded ~ General '~ -""'" Numerical ""'- '-"/ / Photostat ~_ Proofed "'~-L" ,: Scanned """""',"_~.'"-"'= '. ,~ Owner Owner STATEOFNEBRASKA ) ) ss WASHINGTON COUNTY ) The fore~oing instrument was acknowledged before me on 11a.~ \ 'S ,2009, by 1i \ f-.eJ s. m CJ c1C ~~ NOTARY PUBLIC 108 5 o CITY OF BLAIR "},h ). ~ BUILDING INSPECTION REPORT D WASHINGTON COUNTY o OTHER LOCATION OF INSPECTION' NAME OF OWNER' CONTRACTOR' DATE INSPECTION REQUESTED- TIME INSPECTION REQUESTED' PERMIT NO' o CONFERENCE D STATUS CHECK TYPE OF INSPECTION BUILDING: FOOTING 0 DECK FOOTING 0 FRAMING D DRYWALL D FINAL 0 PARTIAL '5 d- ft ~ ~ Foa - S _.' 7N +c. ()...:.ci~ " :... ':r~ o SEWER TAP 0 SEWER D SEPTIC 0 WATER TAP D REMOTE D WATER SERVICE o PARTIAL xD D COMMENTS: UTILITIES: PASSED FAILED o D COMMENTS: ELECTRICAL: 0 ROUGH IN D FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL COMMENTS: MECHANICAL:D ROUGH-IN D AJC D FURNACE D RADIANT HEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL o PRESSURE TEST PASSED FAILED D 0 COMMENTS: PASSED FAILED D D o OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' (j) Scafe. ~ 't-{iJ'jfee;-(c;;"v ~ OfJIR- :v ~(;;.A'6 @ ~~ ~1~;:;:',,:;';~:::t-1J -"~.- ~V -fJ Crt e ~ ~ r eo v t.-,1 If} M A. JJ ~ t::-tU.-bv It. CiL...~ t- c- r i ~ '" N J -ci:~ J -t1Uie- -t-, ;6\..-5 .Fo<~ Si,-L f~tc jJ.1\Jc;{,i.c.~'. f<~fc~cl1-CC $€-c y<uo3.;1.,' ~IQ~ !- So (l. e-Pev\.c!lloC(. _. "'W, S':..(Cl..,J fllcfC-ft..{y" frN.r. , i .... --:U Wi fiUf..;'(;,-1'-j I-Ib~'" (ffl~&I'i<~".(;?L-4:,~' (jf) f {a,O cJ ~ J.e. :; J (,,- t- Fe-t.J':::~ r... IV04.~ i'i cc,..oSe. INSPECTOR' ?1J /}ft ~ DATE OF INSPECTION MADE: L ~ '3 0 - 0 ~ TIMF';2. -:5 ~ s- FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT OF BLAIR D W ASHlNGTON COUNTY D OTHER , ,; /) DATE INSPECTION REQUESTED' I;' - ~I ..po ,j/i~""':7 ." " 'i' 1;, ~,_..;';' ../f,::,';~) l/./i-~._,,}~~)'~>'l !, ) ,/ ,r-. ./ /' CONTRACTOR' \,j/ t: !~;~'J" {~.... ,.r'-,! II .~ '''':~:? ,/l (. TIME INSPECTION REQUESTED' l) (,If) ,{'II, PERMIT i , D NAME OF TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D P ARTlAL COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL COMMENTS: ELECTRICAL: D ROUGHIN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL PASSED FAILED D D COMMENTS: MECHANICAL:D ROUGH-IN D AiC D FURNACE D RADIANTHEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: PASSED FAILED D D -. /I Co/I' ec ~ INSPECTOR' ~ fi!:i(~~ DATE OF INSPECTION MADE: ~"~ O:!-:d.ttf:7 TIME' ,',30 FAXEDOPPDmURTREA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT E/TITY OF BLAIR o WASHINGTON COUNTY ..,\ t! l NAME OF OWNER- /'\ ' '" ,frcR>.. .o"""t~ ,.~'l."""',< i':'.;;S (:,;;'0)1 TIME INSPECTION REQUESTED' LOCATION OF DATE INSPECTION REQUESTED' TYPE OF INSPECTION REQUESTED: 0 CONFERENCE BUILDING: FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL :~~r:.PARTIAL o STATUS CHECK P1\~~ED' FAILED ...LJ 0 COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED ,. "" /}'l~'; t 1"! (::-',y if) ~;.;;, i~t' ,;. .1"1 f l~C: C"'~~: ~~:,} f<' " """~,~.j"':':'.c"'" i I t ! 1 i~' j .t l I L , _:~""~~'i~ ii f:_n^ ~,.;;~:.~r'\, I i I l l f , ti f ,p./oJ/ , ! I I 1 '<'_ -,e:?_~ 'ol''- A"""." ..../ l ) /"! '"'" / /( / ~ ,/ f .. lj(\~,_(-~j l~f..,~? Gi~'l:/(~;1_<~;1:,rC'1/' '''~<\ DATE OF INSPECTION MADE: INSPECTOR' ,l(~l'1J;J (~,? FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR o WASHINGTON COUNTY " ,./ t NAME OF OWNER' it ( r (I , "')-/ /-j(("~' (,_.J/{._c o OTHER /(</"~,,),/),-'I:' /i C;/~-:7 7\,/ ,:'jy!: " TIME INSPECTION REQUESTED' ~'~5, I:/l/~') j' LOCATION OF INSPEQI0N' " -/ / i \ 'i-, COMMENTS: UTILITIES: 0 SEWERTAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 DATE INSPECTION REQUESTED' , ~ /1(/1 //:'.? . (y). ,t;:;",';;/ 1.1 PERMIT NO' i ,,/ c. / (,) TYPE OF INSPECTION REQUESTED: J::2J<CONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL o STATUS CHECK COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: PASSED FAILED o 0 o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' , / .I I /\l~,v>((':/ "l) "'c. ,,;-~,,1 (."J l.t) ,::,' ~__.<)/-} r::'> f ,. /-/ /{..,f~'j;<_' ,-/} L~~j ,--;, ~. \/IG-l/ J t~' /(~) "i~~c1i~:~~~~' (~.'''r(~:) "'// .)~~) , l'_' /t.,.J:' ./~j/. l'.(f:J // I:) <>'c;;; \'..::.:-'L./' ("ii.,.{' /,5- ...-1::-> ,/ ,.,,_~(>""',,/ ,".l.::) ,/)>"',";1(:/ i..;{':/:;/r.':;/j.!/ I71roed Sfru~ rc::' (" /U/..'V-txI ,.1.1i ~I' 4)J 1f41..&t tJ/s/iJr1s~;:: ~2r Ow tterl-- cR.' J /U).f , <;; It' ~ LA{), , 1 NSPECI'OR , K~~ DATE OF INSPECTION MADE: tJ?--CJ6 - """ti:'7 TIMF,3:~O 1~~/e:P FAXED OPPDmURT REA TO CONNECT SERVICE: ON BY " ~, ~,. ja - - ~. - . .,.$ 6 ..- 'f ,~ -, " 'G;] , pTY OF BLAIR :}j,y } ,~ BUILDING INSPECTION REPORT D WASHINGTON COUNTY D OTHER ,.."',,' " ,~'/!'/c:>l (o:"~'!A:., ") l:.,")-~:>{7 \ );/~,/ , LOCATION OF INSPECTION' NAME OF OWNER' /{// '/t_i'C "'\:>1) <) (<lil:~, CONTRACTOR' ~. \ . .:l \ ~ , "/~{,/,?~:- ~ !'nt' "-,' lj DATE INSPECTION REQUESTED' c,.~~;;:.~) "~, (_.J (_/ ,/ /J TIME INSPECTION REQUESTED'" ( .~' 'L,'/' J. ,"'J d<? (/\""/",, ii i' PERMIT ; TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING:,::E;J~:"FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL COMMENTS: 5 Co e ~ d- ft ~ ~ Faa +"~j s -- 7N +'C t2..(.d'IQ. " :..,..~ UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL D STATUS CHECK ~D ED 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 AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERlliSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: PASSED FAILED D D D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' (j) SClJfe- ~ F()of'j tiU 'jfe~-ft;;N ~ 0 fUrL- ~ tJ j fB o-bl~ t2.e r. t) ,~12.s. I N eR.i~",+e- ()jJf,.t i. ~aVL-f~"L Fot1'h~ wILS /IVSfet;..hJ ~ A./~f~/e~ v ~x+. Rr~J INSPECTOR' @ ~~ ~k;':.r~':~:.L{I'1J -UK.- 1<-v d) r ~~ v; J. JfJ fM, A ~ 1I ~ttC.---bv jl. c:-L S. I- c- $' f ~ ~ IV J -r:/;~ ;;f,u,e- i'~ rA..-S S J '- L f L-a. ice jJ. AI c &/'C ~U;' . (<fl..FcfR-c,"-c S'l!-C, ye 40 "5., l.,' t... s () (l.~Pe4lcvr<,e J (J _, ")./w, Sf'(eJII\I rkfc.-tt-~Y' ftN.r. (tJ PI'ou:,J-e, :>;t...t- F~loIeCJ .A vVI p~fe'l..7'i'-'i I-;~~ ?J;J /1.,U ~ {O.(.. ~~~ --f'J D-te ~ DATE OF INSPECTION MADE: ( (J $ fJ #"J l.( ;t.L .{. ~ ) /'J~)C""/, l--(.ofr5e, "'7 - '3 (3 - 0 ~ TIMF' ;2-'5tS- FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY ~u CITY OF BLAIR BUILDING INSPECTION REPORT LOCATION OF D WASHINGTON COUNTY NAME OF DATE INSPECTION REQUESTED' TIME INSPECTION REQUESTED' tee;:?" /) ~~,l;\) f'}'i PERMIT ! D CONFERENCE FINAL D PARTIAL D STATUS CHECK TYPE OF INSPECTION REQUESTED: BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D COMMENTS: UTILITIES: D SEWER TAP'~"SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE ,.,.. :C,., D PARTIAL PASSED FAILED D D COMMENTS: ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL ~ F~ED COMMENTS: MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT 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: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED PASSED FAILED D D NOTES/REMARKS' SC4fP'" C"~t'fe-,J oFF e~.)~ S-~ -'oA<::-hft/. II ~r VYLa V e--JL 1...( 0 \) S e.. ~ INSPECTOR' ~4- DATE OF INSPECTION MADE: 7~' -;;;-9 -oq TIME' r .~t.f-r FAXEDOPPD\BURTREA TO CONNECT SERVICE: ON BY - ............, -c"'~ . P :~ . .-'" '"'" . ,. f!r'''' - . ~~. > - .. >' .. .. ~"o 01-" ..~ . ....-" $-; '- " ..,. ....... .' .'- , '" ~ . < - ".,. ---. .,- ~ -~::--.-. , - - ~ rl ~l , - ~ it '!f~Q ~ -....:.., - .... LOCATION OF INSPECTION' ') ":'1, ....; .,.' -J.."'" ::r ,L:: (; "; (j ,,) o OTHER ( C (J ~e CONTRACTOR' e tV Fe:> ~Ce<NLq.:;f' ) .- BUILDING INSPECTION REPORT CITY OF BLAIR o W ASHlNGTON COUNTY NAME OF OWNER' DATE INSPECTION REQUESTED' TIME INSPECTION REQUESTED' PERMIT NO' ! AJ / A I ' TYPE OF INSPECTION REQUESTED:,';[:kcONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL o STATUS CHECK PASSED FAILED o 0 COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:O ROUGH-IN 0 AlC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o '0 COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' INSPECTOR' "-"1 '/ l,1 "~) ,~,~__:' /__ ,:,"1 -:',{: DATE OF INSPECTION MADE: (~~')',~ {~:" ~. ) t'\ \f ~ I TIMF' ./ ~,", l (,'j FAXED OPPD\BURT REA TOCO~CTSERVICE: ON ,j'.. " ~i,f BY , ! , /IN CITY OF BLAIR BUILDING INSPECTION REPORT o WASHINGTON COUNTY o OTHER LOCATION OF INSPECTION' r""-' .'} ,..,; --'-~., .:.l.,;, f~ "1 ,': 1'<.;,,' '\ NAME OF OWNER' CONTRACTOR' DATE INSPECTION REQUESTED' ,'\ I CS ' () '/ TIME INSPECTION REQUESTED' PERMIT COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o "'1;] '. ..",'" ",\;;" TYPE OF INSPECTION o CONFERENCE o STATUS CHECK BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL COMMENTS: ELECTRICAL: 0 ROUGH IN [] FINAL 0 PERMANENT SERVICE o PARTIAL PASSED FAILED o 0 TEMPORARY SERVICE 0 PRECONNECT PASSED FAILED o 0 COMMENTS: MECHANICAL:O ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' ") ,( f) Vi} . ) ( l_. "1 t (' "L,,' { t' I U "17 ( ,:',:, L,-'- ! .\" I"'<',{ I",',,' <"';,:>- )- -' :' ('~" r:?c:'" 'r \ (i vL /' , ~; j l/">! l-l t'> u' { l)l r i l, \ .I:, ~.. .',;' /,.,. i ( \"_ __<,_'.i r 1;f\~_} {TJ .{. J:.~j c>~:; {_If i''-'''/ i,.:,';li"",,e <,J Ll i (') i/ J' INSPECTOR' ,..., .,< ,/"";1' </,!.>,/,.;-c,:' ,,-',_r' DATE OF INSPECTION MADE: 1/1 ,~ TIMF. ' FAXED OPPD\BURT REA TO CONNJF:CT SERVICE: ON ,,'C... BY .... v. ::~t;~~ ~~.:: ,~ _ ,- - "~_c~ 1'. -4-,"' _...z --...:.k.' 4.' . ':.~~\",,, L.:-it.,"" -.c,.~~~ ~ ....-.'-';;:. '__:-:0 "a~~ ., ..,.-~-~ . ~ -..,~,- 'H,','t.. .~'.. . ,. ~ ~ ~.:;..,,- ..~.~ .~\.~",_;>t.__ _,...;.";);.~a. ".,,' ~ , , ~~- ...~; ~~!J-~.~ -.. ~ '~:~:iJi-- :1.: - U\.~~;..2_(."7 , . ... ,-~'"f.~ .......~ - .... , ... . , . ~. -,- .. "'-... .~ \. ~; ..... ~'<!;:\,;,~ .~, ~1 '1t"l ill ~.- - '. ~ ~ ..a.t. - ,.... .. .' ,~'.,;--- '---'<.,:- ~ ," oW c '. ," ~ . , ',~ .:-. . -' , , "'\,- .- -, , -,' . ',,,,,-- ~ , "'- ~ . - . ... , - ",' <~..' ,,,,' ---' ~ . , , ; ~ ,~_.. .h; .~ ,"'-,.. \,.. t ~ k: ". -' ~ , . . . - .~ =.~~ ~- ~' '~"~ """". -f''''''''' . ,-...... . . ~_ '1(-.- '" - - - .,..' ~.....~ - . """'l '< ',' ,~.tt-$F ..'""-' . .~r- ~. - - III .. .~~.a...!'_ .., 1t~ _.~ " .. ~__.,...n.~__" _ ~"";'"F' ... .ji:~ ...;;,:jr"~ ;.;c.- ~.... -~,~?..~~ ~ ' '-,- ~"',,~ ",~",,'.~~<j) ~. -..~~-i-.~~~. -it . _~~P'~1::~~":'-'-.:~~_- _i'.~ '~~Jf;\.-"""~_.)..:,t,Pii.."". ". . ~~I~tI~~.I~~~;At~~~~" . ~.Af", .~~~.~ .l-'"' "1"'-'\>";;'1. ,~ '" ....:~.:.J ". ~~~5t.. \;,.~t... \.<~'5';--j[..~~,.......;- n~".'''''':''J..,~-<:<,iJ;''m''t..: ',i(.J,,!\;"k,," .," . ',"<>; " '" ~~c "..,..~' "'" .-'- ';"'""......... ...~.~ - " -~.I."\;"-"~ "'t... ~ . .. '" ilIt\' -" ..... , ",'~, .' - "'''- , ..... :'\ '1-',"' ,'.' ~ . , , .. . '''-. .....' " .~ , ""'I"'" ~...~' ....1~ ........ ~'i; .. - ~.... .. - -~~'" -" 11><.'1 ,~ .. ,00,' .,. ~:., ~~ ~.. '., ~ '" . .0.'- ~ -~..."~ - ~ , . <,' .' , , . . ~. 'r .~ . . ."*" ~...... ....." ....,.. ,. "''''!.<< ~. ,~, '\ " *~~ IS CITY OF BLAIR BUILDING INSPECTION REPORT o WASHINGTON COUNTY o OTHER LOCATION OF INSPECTION' "" _':~! r' .),) .:-'f'. j ((~'- ! ..c-. ;.- C' c, y,,,,/ ,",..,- .~ NAME OF OWNER' CONTRACTOR' TIME INSPECTION REQUESTEt), ,t / 1:.< to "~I Lt. "/~ f DATE INSPECTION REQUESTED' PERMIT NO' /~::< ~,,:- {~S,.,/ COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 TYPE OF INSPECTION REQUESTED: 0 CONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL o STATUS CHECK COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED PASSED FAILED o 0 NOTES/REMARKS' "",' j I;";":""~ 1;(0 i';~ {:'iA. I-/ t , l.,~ " i/I.J ';(" ,1 / ~" <;:(1 ,A / t,"-' l/"~~{i?~) {;~" < 'i/:' _~f I'.. /,. /1.1..1 \;,; /1\,) i} "1L (:. j' )" l f .,J l' /. i..il ( \:" i],r:? }.. (1 ::~~ () tl:: "lel}t) f' OJ' , /"{~.f u:;: /:;:,~' ,.' ('if j INSPECTOR' i;~/',-, 'i ",c,"';, .. "/~},~_ DATE OF INSPECTION MADE: r-Y1 '.':.) ,~.) ~Y l (-),.~ ()_, TIME- ";:~ ~> .1' !')' t::1 t~;;/t FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY . , . , g. '......<,. .~ . ... ,> . ..,..;'" ,'~ . ~'~':. / ~. il'o '.": . Ii'll'. a' '~~.~:.' ~CI a ~ , n , . " - 11~ D CITY OF BLAIR BUILDING INSPECTION REPORT D W ASHlNGTON COUNTY D OTHER " NAME OF OWNER' LOCATION OF INSPECTION' " , Ii , ~ N ~ 1 f \.-r" ( ~ ~<; I, ) <<, (JI,c t:~";).,,./. /:1",/' ,if CONTRACTOR' ,!~i 'C ) {::,' DATE INSPECTION REQUESTED' (':,}'! ,i./ ..' k TIME INSPECTION REQUESTED' -<-'\ ~ it ~ PERMIT TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: );(:OOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL D STATUS CHECK PASSED FAILED ~. D 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 AJC D FURNACE D RADIANTHEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: COMMENTS: 5J;,:GROUNDWOR~ ~OUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL D PRESSURE TEST ~ ']:iJ) -\-6 l.. L~-4tC>-''V J- \' -e s 1:- , PASSED FAILED ~. D D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' INSPECTOR' ~ 't/r4 DATE OF INSPECTION MADE: ~(4l.N~ k IO!AW\~ A~I;jJ ~"- ~7 -0 f TIME' I J;'f+) FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY ( ->' ~~ ~,-~ ---~""~.- d~""'.. ~._... ;:t.;.~..,.-""= ~~.:;:.:"-:'- ..,.. ./ , - .~ ~ ~: ./ . ~h." ~ , .~ .., '. ) . It., , " . ,~. , , . '0:" -, - . ,. r.i . " ,'~ , - ..;;...-:;. -~~..~ . , " "OJ ~ . ~-',,;.;. ~ . , ~::' ~- . ... "- -, or'" -...__1 -'~'. "' , - -,,-~- ". .... ~ -~ r - ,- . ' .. ..... .~,. - . " g ~ of G:'~' It:l BUILDING INSIFECrrION REPORT CITY OF BLAIR D WASHINGTON COUNTY D OTHER LOCATION OF INSPECTION' .>;?::,:(~;,'? (/;; (i ,l, )(J,?; ,"',....,......:i ;/,,,,./ ~ ,,' " ';) ,I \/ /f''''' CONTRACTOR- ',j..", ' (, t-,..,~ ;'/)' (, lr:. J )') DATE INSPECTION REQUESTED- '," ((,') l"~,;/ f't "ef/'ll, _,' J' '1 .' ,.~, ',/,; _.. ':,i . ~.,;,r'l.j1 l il'.. {:. ,.'! ~,u PERMIT TIME INSPECTION REQUESTED' TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL COMMENTS: ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL COMMENTS: MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANT HEAT D FINAL D PARTIAL COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST COMMENTS: D OCCUPANCY GRANTED, D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' I r, , , p,;! ,0 {' C ;,:() ,. ! t <\ '~ \,) J (} ( k .I, l,' ,j A; (; I:} I ~{. it:", (,J '" .1'..,.>.' /\/ /~'{ :' i::,).I lc'" l) ,o"J- ",.., ! l,~ ' (:.t. Ij (',(-/, . i" (; ~, {} It V 'e -Eo A l A 5" k. ft.? t<.. ,{. ,v)y -{. C> 5e"C-~ t',cii;.'d"J ~ AL, D STATUS CHECK PASSED FAILED D D PASSED FAILED D D PASSED FAILED D D PASSED FAILED D D PASSED FAILED D D ~)' l.!)' f,/\;,,,,,l "j-l .in (}~ L~~J i ,lC}' ( ( t,) .'\ r:'J~- Y --/ {,,~{ ro.:;" ,---, ;; {' 1 1 1,;1' J"Ur "~~;~ ( -rU i'L ( f) ! ,({ j ,f"" \, l~ -; f'- P)i:?,.[) f["'C .. L L ,/ ~',-l'\'/' () ft" \" \ \ \ ; " ./ t;_ " ~ f)il ,) / f,_j ( .. ('{I i.. lA, 1:,f/ i '~. l{ '_ _'_<,1 '. {(~ .,{~ /<r { /'.. L l(:~'i 'i,7< (1' (C, i' -~f;, - to J~,:~Ji';7 .'~,,.u r!'~l /"'r,) ,,(j '~ INSPECTOR- '"~''''''''/\l' '/.'1" DATE OF INSPECTION / .'.':!\",<) FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT OF BLAIR D WASHINGTON COUNTY ) ,~i NAME OF CONTRACTOR' / fA! ~,/ PERMIT NO' :?;~ y~l (J ~ ;.' "-'>- ( '" DATE INSPECTION REQUESTED' i t l /'"L'-,~~ t"~l TIME INSPECTION REQUESTED' TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL D STATUS CHECK PASSED FAILED D D COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL PASSED FAILED D D COMMENTS: ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE'G;J,'TEMPORARY SERVICE D PRECONNECT D PARTIAL .F ~~ED COMMENTS: MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANT HEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' INSPECTO ~PD\BURTREA 3:>P q..pl~ch DATE OF INSPECTION MADE: c:;:J...(! "'~cr TIMF' Je)~'.$D TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT o CITY OF BLAIR o ' WASHINGTON COUNTY NAME OF OWNER' CONTRACTOR' DA TE IN~PEcrI6N REQUESTED- J -<,<1 ' /,,/t ./ /~/i 'J (~? ') TIME INSPECTION REQUESTED' ,/ U' () () /'.J, /(! ,f, PERMIT NO' l) ':;/ TYPE OF INSPECTION o CONFERENCE o STATUS CHECK BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL..[:J'PERMANENT SERVICE 0 TEMPORARY SERVICE' o ,PARTIAL COMMENTS: ~ F~ED MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: DOROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: o OCCUPANCY GRANTED 7b Atf~ Cr df1~Y"G-'/?Jz;.1/J S'etJ/'U/~(O tI mSPEcm.?~ ~PPD\BURT REA " TO CONNECT SERVICE: ON ~~. {O-'8~()9 DATE OF INSPECTION MADE: /tJ '-()V-rYf TIME' / () .~L5" BY ~ ' " ~. BCITY BL R BUILDING INSPECTION REPORT o WASHINGTON COUNTY LOCATION OF r '>, \ l !['-:.;."~ ,;1 ,__ J/ CONTRACTOR' J)i("l~ ..5;~' <;<,' < " If NAME OF i'" DATE INSPECTION REQUESTED',;' (j /;;'{"J:"?' t";'~>ClO! TIME INSPECTION REQUESTED',/l{J I'); ,. P5/..j~1, PERMIT TYPE OF INSPECTION REQUESTED: 0 CONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL o STATUS CHECK COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICA PASSED FAILED o 0 COMMENTS: ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT PARTIAL PASSED FAILED o 0 j' MECHANICAL: 0 ROUGH-IN 0 NC 0 FURNACE 0 RADIANT HEAT 0 FINAL COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: on /o-.:;l9.-cY)- 9p' 3d /:}-~ ..-- /}'7Q'/~ I~(/'e. k- ~c< ~ qJ j/(:""4' NOTES/REMARKS' '/;'.:5 fer- C~tJer I bJ . If .s eC7; ..s -db // r ;20 17\. R~ e: ?:eupt~I"~//f~. er . /' ~o$ oK ~~~,~~ /0 ~CY-()9 9:.J?S INSPECTOR' /';1 ?c ,/",:,/:,t:""I)"'I'!',/~~; " (~j;'j\\ t. "",' ", _'~, f DATE OF INSPECTION FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY Q~BLAlli BUILDING INSPECTION REPORT o WASHINGTON COUNTY o OTHER NAME: bF "'<"'..../ f """(,,,i(y,{', ,:/~ t::i (,;~ :',,4~'<'~ .,,~)" {~j:/7' . \.:' CONTRACTOR' """""""""",)."','"'\,,,,,,/ ",,"',"", """'"""",,,,,,,,',,',',, ,,',' """"", . "m'~m ",', " 0'<'".' (_~':"AC~~.~'.;~.:','~~ ,,:,,;:',~/i,,!/' (." i: DATE INSPECTION REQUESTED' if',,"', ! TIME INSPECTION REQUESTED' / (), tj (),4 iff, ' PERMIT TYPE OF INSPECTION REQUESTED: 0 CONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL o STATUS CHECK COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAl,.. COMMENTS: ELECTRICAL: 0 ~OUGH ~AL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT COMMENTS: ~RTlAL MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 PASSED FAILED o 0 PBED p</ COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: PASSED FAILED o 0 -. ~T INSPECTOR' ~f?JI3t~mOFINSPFcrIONMADE' ID -,;?7-Q/ffI'r1ME.jO · ( 0 FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY ~ Oct. 26. 2009 12: 05PM TRINITY LUTHERAN CHURCH No. 0078 p, 1 October 26, 2009 Chris Robinson Washington County Court House Planning & Permits 1555 Colfax Blairj NE 68008 Dear Chris, This letter is in regards to my recent phone conversation with Dick's Electric, I was told that you would give us an occupancy permit to live in our basement at 222 Jackson. To do this, we agree to 8t81t renovating the main level of our house within 3 months of occupancy and complete the renovation within two years. This renovation will include new wiring to bring the house up to current code, If there is anything else that we need to do, please call me at 427-5640. Thank youj ~~~ Kenneth & Rita Smock LOCATION OF INSPECTION' BUILDING INSPECTION REPORT , fl t. / R-e N Ctl.J:"{i:. tSO..<.e.~J-- f.#IN~OAf:;; W A~GTON ~bu~~ e LJ OTHER, 3 i) 6 -/- ,d-.l/- (. t ( ( j" ~~ J -3/ 8'--'~ .[]<,~ITY OF BLAIR D ,l~/ j j NAME OF OWNER- r: .' f2,'/I;,!{/) ;//1 l < f .~ /(_ l T (. ,,'f : -~ -~.', rT f (~f It:i,~""_:J -, CONTRACTOR' , .. /:. ' . -.. ,</,/ /,,/,'//' / ,. ,(,~:' ~ .,( ,,,' ;' l.:.;; ".~ ,) '( ;,~>" J /,' c") (":':/;,":1\ < J1ft ~ (/ .I j DATE INSPECTION REQUESTED' I i ,/:.J._\ ,_,'_ "v), ,/'~')(>'l (/ .? TIME INSPECTION REQUESTED' i PERMIT TYPE OF INSPECTION REQUESTED: BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL COMMENTS: UTILITIES: D CONFERENCE D FINAL ~,::,JAL ~<,t./ D STATUS CHECK PASSED FAILED D D COMMENTS: D SEWER TAPcpl2J'::SEWER D SEPTIC D WATER TAP D D PARTIAL () tN1 () V -e c^ r-.t Ou.'i ~ - S e\"v e<Z - r2rz.<.v'(. 0 f-=- f~v 1I~' . ""'~" ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT PARTIAL 6- \Ai dv'\elJl:.1 T A f' - J'e(j,J;(C e. . REMOTE :123-:5v A TER SERVICE f,A ~o.f ( eLL PASSED FAILED ~. D ELECTRICAL: D D COMMENTS: PASSED FAILED D D MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTESfREMARKS' <1) 1e':'V(~ <::;-etlj/,ce f\lo + v2Cc.ut'j CalL. h'~IIf>Jl~ OK 'lv~ INSPECTOR' 111J 1~ DATE OF INSPECTION MADE: Jd-'lj'"t"J~ TIMR' I: 50 fCVL FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY Vr j-d-. 1S21;::eiTY OF BLAIR BUILDING INSPECTION REPORT D WASHINGTON COUNTY D OTHER LOCATION OF INSPECTION' /1,./' { NAME OF OWNER' j<" ....~. '~< i (:,,~,>:/' ( i/ i::/ ( ,l:~ ,::')/;', )'( f ,A )' ../ , , -;.;- " i..c., l '" DATE INSPECTION REQUESTED' " \~f;' ,/~fi /~/ TIME INSPECTION REQUESTED' /i'.~),' , :'] t..'~1 /{! ' CONTRACTOR' {~~) {~:ii' PERMIT TYPE OF INSPECTION CONFERENCE D STATUS CHECK BUILDING: FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL COMMENTS: UTILITIES: D SEWER TAP D PARTIAL e.... SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE PASSED FAILED ~. D 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 AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D PRESSURE TEST I WATER METER INSTALLED D PARTIAL PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTEr> D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' jJ Dt~ : { I~ I () , to" FI4W1tt rfi.-aJ ..v". t1~(<. ~/.cJe. f / I- !kC tit'! (./~, - 6V..... i 'j f-~W\ ~t..-& fuVl-ct-' - of\. i\J of-t: ~ N 0 t u < LJ.-~ 5' f-CLtA y ncJt~ :5 ,(. ~ T R z~ T~ - tit t'5 cS' le",eyt-'-'''-f. ~A.... o^'-( -- A 600 sJ ". - fitfi~ J f')-t( ~~r' INSPECTOR' '1t '}1) ~ / DATE OF INSPECTION MADE: L { -l-:J.. -0 q TIMF' J () ;'1 0 A CA"1. FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY OF!~' BUILDING INSPECTION REPORT ft.JA wnh 151<t-( H,~I;f!): k;f't - t+.:'.} ')./ :;/ (, '+0 D OTHER D WASHINGTON COUNTY LOCATION OF INSPECTION' "7 J: (r)('" [_' ,J { !,'ci t.,_ /J' (: :; (!~ Jr, .' , , 1 '<~; /)'.~ZT1o-_/ ;-...,. \ ~i ' ~'" j NAME OF OWNER" .1./. ,^:rri ( {/,;F: / l ._-.' .; li'~ DATE INSPECTION REQUESTED' !! '" .ti:'~. CONTRACTOR' l:.,.Jl~;!~/;' l'"./ A..~} 1(1 Ii t' () L ! #., - TIME INSPECTION PERMIT TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING ,.C2Jf~'FRAMING D DRYWALL D FINAt.r..~ P,aitIAL COMMENTS: D STATUS CHECK ~ED F~ED UTILITIES: D SEWER TAP D D PARTIAL WATER TAP D REMOTE D WATER SERVICE PASSED FAILE!;> 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 HEAT D FINAL D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTED NOTES/REMARKS' CJ D CONDITIONAL OCCUPANCY GRANTED A I'J t'7,€ (J U,€ -i--fy.r v't- J.~' 1< (~ I I I ';1J Nw, O;':)~-o-wrt-S - J~ 'A~~~' INSPECTOR' A7 qJ,~ DATE OF INSPECTION MADE: J(-lb-6C) TIMF' 8;: (r;/4~ FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY tj1J< BUILDING INSPECTION REPORT .CITY OF BLAIR o WASHINGTON COUNTY o OTHER LOCATION OF INSPE"9TiION- " ,/. /'-~';'$'1.,;:~:) /~~:.:? i' ~. ( >,/~,::l (IA<" \,>~\"<:7'~,jZ;--~,,,,,, r (\ ))}.; ::,., ')"-/1) ~~.;:; (""'A;~_:~.- CONTRACTOR- \~~f} l(.J NAME OF OWNERf<. DATE INSPECTION REQUESTED- l, " . ! f l {~~,:::J (~/Pl TIME INSPECTION REQUESTED- i' / f ,r.","'1t' " , ,;: '(Fj. PERMIT NO- I J ,,~"I 1='/.;/ <>: c.:"J TYPE OF INSPECTION REQUESTED: 0 CONFERENCE BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL RrARTIAL COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL o STATUS CHECK PASSED FAILED Y 0 PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED 0 0 PASSED FAILED 0 0 PASSED FAILED 0 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL COMMENTS: PLUMBING: 0 GROUNDWORK:J~2}(~.ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL o PRESSURE TEST COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS- /et.1Nf \/evt-\ (::O"tC {:::,-fc:kc;J ,5t,Jk Ir{<' 'uArtrl /.--ee-{-'-iJL /NI'<; lA/{;rfO'C.I' INSPECTOR- ~~1p/ DATE OF INSPECTION MADE: 11- 18-61 , TIMF - 4- f" tr\. FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY ~ D CITY OF BLAIR BUILDING INSPECTION REPORT D WASHINGTON COUNTY NAME OF OWNER S> lv, I, ~Lft., ;~) ,) )- . li",\,- ,-,..-. Ii '. j '-II J ...i,.. i.., \ I 'J"" t _pi ,.J f D OTHER (J2\'A/~)/l{: 1 ! I LOCATION OF INSPECTION' L r CONTRACTOR- DATE INSPECTION REQUESTED- \ ) '% \ f ~ " ~ i ~ L.,\ TIME INSPECTION REQUESTED- / PERMIT Nb- '.): -;) ,,-,";,~,;:~ TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL " "'STATUS CHECK PASSED FAILED D D COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL PASSED FAILED D D COMMENTS: ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL P ASSED FAILED D D COMMENTS: MECHANICA : D A/C D FURNACE D RADIANTHEAT D FINA ARTIAL PASSED ~. D ~: COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTESIRG ~I ,0(20 Iii cle- f el!4"'~ K ~;.s - k5+'~ /~ve... A. l...L.(1 w e SL.. FLp-y 8tt S f-~'f'J~e +0 S' f(o ",J INSPECTOR- 7t.v+ DATE OF INSPECTION MADE: Cd-. -/ (- () '1 TIMF.- JrPM FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR o WASHINGTON COUNTY 0 OTHER , "",;;'",",',?,','"",,'~";,:)',~~""':"'~") ,.~.; ~.r' ,,",' " .~.;~!',~",",~,,","!i.,1",:~,' " ",', ,'0 .. ", t~J.iJ(",,;~.( ;;.1:" _'~:\~<)--~:/;: ',"', \,' , CONTRACTOR' /"\/I'i,,!~>lJ (l,:,;/7l;,l/(;~ NAME OF 'I ,";-< ,-' .,.,.\ DATE INSPECTION REQUESTED' ,/";{ , j ,') .. () '1 ./~ , ,..>--; /,.) ~~""',$ .'''' ":'.! TIME INSPECTION REQUESTED' ./ ('/ l i, C ',,/1/'1; 'PERMIT TYPE OF INSPECTION REQUESTED: BUILDING: 0 FOOTING 0 DECK FOOTING , feCi. {;{ o CONFERENCE o STATUS CHECK COMMENTS: o FRAMING 0 DRYWALL I y" UTILITIES: SEWER 0 EPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE COMMENTS: ELECTRICAL: 0 ROUGH INt8;:'i~'INAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT '::E3;,'p ARTIAL COMMENTS: ' MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL PASSED o 0 i P~ED ~ COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATER METER INSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: PASSED FAILED o 0 '~~CI(~ ~~' fh'h (:1'0 ' D t INSPECTOR DATE OF INSPECTION MADE: /(;2- /E:-~ TIMF' )() .'OS-- I I FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR o WASHINGTON COUNTY o OTHER Lf-:}1," F;' I; ~() ! :\ (:.j/(i (~~, i-~' :,5: l::rll "~} . DATE INSPECTION REQUESTED' CONTRACTOR' \~::S:,,:i;;;(" l" NAME OF l~r f TIME INSPECTION REQUESTED' i,l, ,~;?(}1'l1,,1 ' PERMIT TYPE OF INSPECTION REQUESTED: 0 CONFERENCE );ISJ'STATUS CHECK BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE o PARTIAL PASSED FAILED o 0 COMMENTS: ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT o PARTIAL PASSED FAILED o 0 COMMENTS: MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL PASSED FAILED o 0 COMMENTS: PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL o PRESSURE TEST PASSED FAILED o 0 COMMENTS: o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' CD f~ V(,~:tQ. ~ f~ ;A dJ2~t5\ (fA! f-,io1v-f' (ff? {(.d~ INSPECTOR' '141V+ DATE OF INSPECTION MADE: t~ -;;)./-0 1 TIME' 11~J'<l FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY ,Af-C WtJ"Lk --- J,-f Ii~J<~ ;"dSe L 't1~q;; _;l</I~" - is i;J--;)-t-o? ..;;:\)\~ cO \ ~~~ x oJ ~ ((f - ~ '- " ::::J.- " :::. "1 " 0-) (~F~ '\ ~ pc ~ j 1(') fJ() fJO g [3208 .r; ~~ NO l--c "' IJ L (?, ~-ISL- L: 1 &-1 fJO J l-} ,~ BUILDING INSPECTION REPORT CITY OF BLAIR D WASHINGTON COUNTY D OTHER '4:!^~~~.;?d~~'::~/ .;/,,~? .;:~"~, ,'. \\- "r_l I"."..",,~ /(' ~ .._ <', '-_) ~/ NAME OF ~: "-"~-)"'. ;:<-,.,/://~" iY DATE INSPECTION REQUESTED' i TIME INSPECTION REQUESTED' i/~;/ ,,) ll~,/i[,/, PERMIT TYPE OF INSPECTION REQUESTED: BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D CONFERENCE FINAL.r2k;~p ARTIAL D STATUS CHECK COMMENTS: 6g t-~w' PASSED FAILED .Et D UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL 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 AlC D FURNACE D RADIANT HEAT cLJ':'FrnAL\G]'PARTIAL PASSED FAILED )gl D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN ,ld";:'FINAL D WATERMETERINSTALLED,,:~;,PARTIAL D PRESSURE TEST PASSED FAILED ~ D COMMENTS: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS' CD .A f 1~lA-{)V ~L 'is l'fuvJ~ Fl~,-4w.,(j;A L /:C~ttL ~ a -" f./ It) eUJll- ~~ /-r /l)( J k. @ d~ bvtLLL tA/d.LL c ( P'f~4~ ~L...ect Af't#e61..1'~ - leo"jU ,;J) CD ~ ~~,~~ )~{l'wt (?~~t."t'I..,f./~_~~ -.yI,Q. 1~ S ~c;K: @ f(t.ov\;Je 5'~~'t' (1) ~t,I/-::t;^ f~~ Aft'L.<.du>v {7;tZ INSPECTOR' ft ~~I ,. i:?e..-bf't"to~_ , f- c;A- ~o.st l1 U -t.$'relf/ r;a.j~ fh(3e.t.,.,,/~ ~e/.~"'(JA.e./L- DATE OF INSPECTION MADE: ID~A/AtA., f' TIMF'/oI u- ).ot O. FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR D WASHINGTON COUNTY D OTHER NAME OF ...:;:~:~1.,:_;: t "j~i/ cE /it;,/~:).(J}'"} ',\~j/,i~:r:i:" ( ! " '\;;' t _.J i j 'o? DATE INSPECTION REQUESTED' ,/ ~;;;;:() / t) TIME INSPECTION REQUESTED' / ,A/ I /', ," (" /1 ,//'f PERMIT NO'! "') / () , /) ,c" .' . '0. .,~ .~,.. ;".."... '," '. ..< TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL D STATUS CHECK PASSED FAILED D D COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL PASSED FAILED D D COMMENTS: : :~- D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: \ *-, DATE OF INSPECTION MADE: () 1....;2,6"':~4tt? TIMP.j {J ,. 6 S' . INSPECTO . FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT CITY OF BLAIR D WASHINGTON COUNTY D OTHER CONTRACTOR- .: ,~)\:0~i'j;/') (~ f n / !" . \,./ / NAME OF / ; ) '~ :1"(' .:,;:';~>i 1".~~.;1';, (' ,/~'fl'!.../::::!)'/] DATE INSPECTION REQUESTED- // .,,'):',?~ ::;/ ,.r (;~:~'; ~~~::?><~:> TIME INSPECTION REQUESTED' ,/ (__':=;~:~~/:-! "~<l7 " PERMIT J/ TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL D STATUS CHECK PASSED FAILED D D COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL PASSED FAILED D D COMMENTS: COMMENTS: MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL ELECTRICAL: D ROUGH~:l~~r:FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D PRESSURE TEST WATERMETERINSTALLED D PARTIAL PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS- DATE OF INSPECTlONMADE: (){ -- ~ 7~ .-:J,.cJ/tJ TlMP' / :3d INSPECTO . FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY ~FBLAIR LOCATION OF INSPECTION' BUILDING INSPECTION REPORT D WASHINGTON COUNTY D OTHER _"~",""",,_,,'~)'~,,,,,;:;,,) ..'...:-,....., ;" 'I ~ - 'I ,{ "" ," I'~ {/. / '..:., ", c, - ',_" {~.'" ~/l/"y (,~r~>;:'.,~;~,~_::.) "5'~,;;-' I \,,, J;v:" ,.. ."e}'-~), j r ""> /.-, NAME OF OWNER- /~::.'/ ?,.~i., )17}} f:.l(7iL CONTRACTOR' . ,\:':,(1,/.,/) , j DATE INSPECTION REQUESTED' :>' ~:?" ,;~,/{;)/'{';' TIME INSPECTION REQUESTED' ./ iv',_~~;;~~~~~.~,:i o,.l?l .. PERMIT TYPE OF INSPECTION REQUESTED: D CONFERENCE BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL D STATUS CHECK PASSED FAILED D D COMMENTS: UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE D PARTIAL PASSED FAILED D D COMMENTS: COMMENTS: MECHANICAL:D ROUGH-IN D A1C D FURNACE D RADIANTHEAT D FINAL D PARTIAL ELECTRICAL: D ROUGH rci:;B'::FINAL 0 PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT D PARTIAL PASSED FAILED D D COMMENTS: PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL D PRESSURE TEST PASSED FAILED D D COMMENTS: D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED NOTESIREMARKS' ...... INSPECTO ' DATE OF INSPECTION MADE: Dr -- Ot 7~ ;l..o/tJ TIME' / :3d FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY bd CL i o d c� a V.:� h. CD A o' CD � G 1-� TT� V1 CD ol U ci cD CD O �C W i CD CL �. CD o' CD � w N 00 9 CD M V1 O �' UG ( H C r+ CD ( D CD I-t C) '! O 0 CD o + ¢ o cD CD � L n �i o ° g En r p ( D '! O CD � • o cD CD � u PP+ 0,-, v d CD aC'D rvl o � ° I ° o U CD o � o _ CD n ° cra o CL CD e O 4� u P E--a C Un "G o' 0 T D V1 Vl CD !", CD CL CD W NMI '. cD OR CD � w CD 00 V1 ✓r o � � 00 CD 0 CD CD CD O 0 CD 0 2 • CD r. r• � r CD CD o = UQ CD CD n O OCR 0 n O CD ff4 O CD CD uq NAME OF OWNER CONTRACTO DATE INSPECTION REQUESTED � a �` TIME INSPECTION REQUESTED ty PERMIT NO TYPE OF INSPECTION REQUESTE _ ,CONFERENC El STATU C HECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL - PASSED FAILED ❑ ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL F] ❑ COMME ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENT MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL FAILED El PRESSURE TEST F-1 El CO MMENTS: -- - -___ ❑ OCCUPANCY GRANTED ❑ CCONDITIONAL OCCUPANCY GRANTED NOTES /REMARKS S 0 Q 1 , C r- ( / a a vii JJ Gc ✓rt INSPECTO /' DATE OF INSPECTION MADE: ? — I ?- ( () T IME FAXED OPPD\BURT REA TO CONNECT SERVICE: 0 N BY