BP13308
~~~1 ~f- ~S~::~(~~~UtING PE~~~ff'".n - ~uf
Permit # /3308
Date: q --073 ~OqAPproximate Completion Date: cr-3(J-01 Site Plan Attached:
Estimated Valuation of Project: 4d. Of). 00
Application for: Permit Fee $40 + Issuance Fee $25 + $50 Deposit
Fee: $115.00
Egress Window (floor plan drawing required)
Fences (plot plan required)
Gazebos (plot plan required)
Patios/Driveways/Sidewalks (new or replacement)
Roofing/Siding/Soffit and/or Eave Repair/Gutters .~
Swimming Pools with Fence (plot plan required)
Window/Door Replacement (size change only)
Miscellaneous Building Permits (items not covered by one of the above)
Description:
Utility Excavation and Curb Grinding
Curb Grind
Length
Utility Excavation
Length
Type: Water
Fee: $75 plus bond
Un. Ft.; Width
; Sewer
Un. Ft
; Other
Amount of Bond Posted: Bond Check #
(Curb grind - $9.00 per Un. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
PROJECT INFORMATION:
8?t?o <tj& 18U?
Job Address:
~ //~tJ ~tlM e5'!:
Legal Description (if applicable) J?t! o({) t- 9 f ?'If 1:1 /lAi! :Sf ElL? I II d pC! '1
Owner:()~ i?oSfM111CU'1-- Address: Phone#: 'IZtj -38tJt]
contractor:'---~htl1 i( 's foiJn :1:' . Phone #: t/ 2/iJ -;1;< '7
Address: dL/tJ() (J II~ tJ J!cI Cell #: IY 79 - ;U35
ciflau Ale uc3oo!3
PERMIT RENEWAL FEE:
This fee is based on the amount of the original permit fee and is charged when work is not
completed within two years and the permit expires. Renewals will only be allowed with the
stipulation that all exterior site work and outside finish work is completed and interior /ife-
safety issues have been properly address. Permit renewals are for one (1) year, with a
maximum of two (2) renewals for a maximum permit span of four (4) years.
Original valuation of $0-$50,000 $150.00 $
Original valuation of $50,000 - $100,000 $200.00 $
Original valuation of $100,000 - $500,000 $300.00 $
Original valuation of $500,000 or more $400.00 $
Issuance Fee:
$
25.00
Deposit:
$
50.00
Total Renewal Remit Fee = Permit Fee + Deposit + Issuance Fee $
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic
systems. By my signature below, I acknowledge this building permit application does not constitute issuance
of this building permit. I further agree that construction covered by this permit application shall not be
commenced until I have received a copy of a permit signed by the Building Inspector. I hereby agree to
perform the proposed work in accordance with the specifications set forth above and in accordance with the
cOdes/ordinances of the City of Blair and the State of Nebraska. I understand that this permit is void if work
is not commenced within 180 days or is not completed within two (2) years of date of issue.
tP?~~
Signature of Owner/Contractor
.X::r r- 2 ~ /c7,9'
Date . /
For Office Use Only WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit Paid: 7-;J]JOl Receipt #0163 II Approved by: ,3- 1!.f! I~~
~/~
D CITY OF BLAIR
BUILDING INSPECTION REPORT
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
NAME OF OWNER'
DATE INSPECTION REQUESTED'
CONTRACTOR'
-() Y TIME INSPECTION REQUESTED'
PERMIT
TYPE OF INSPECTION REQUESTED:
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL
D CONFERENCE
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
;8rD F~ED
PASSED FAILED
D D
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANT HEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL
D PRESSURE TEST
WATER METER INSTALLED D PARTIAL
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR'
7<;/V.r4f
DATE OF INSPECTION MADE: 9'- '3d.. 0 'I
TIMP' 11.'?c )~<1rA-
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
Permit #: 13308 Issued:
Completed:
Location: 1140 South St
Owner: Jim Rosterman (Holding a 50.00 deposit)
Address: 1140 South St
Blair, NE 68008
Phone: 402 426 3808
Section:
Subdivision:
Township:
Blair Building Permit Detail
9/23/2009
9/30/2009
Type: Roofing permits - All types
Valuation: 4200
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
Range:
Lot: 9
Block: 71
Tearing off down to decking, replacing with one layer of asphalt shingles. Holding a 50.00 deposit.
Contractors
Denny's Roofing
Remarks
9/24/2009
9/30/2009
Inspections Date
9/30/2009
BMP
HOW
By
HOW
General Contractor
Permit #
Holding a 50,00 deposit until 12-24-2009
reroof-final-ok-hw.
Final Inspection of Project
Pass
40
25
50
25311
Issued
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS,
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
~
~
,,>0
~
. "'l 0....
promi5e
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,
~diti~n or accessory building valued under $10,000.
( t~5~~undable deposit is being collected for all misc. permits.
~i1e--Gity reseNes the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) Theft of water seNice 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.
?:.5r::;~-
Contractor/Owner
Contractor/Owner
City of Blair
!~7~~
Dat /
CITY or 5L1\IQ
ROOF PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and/or roofing permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2006 International BuildinQ
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
I have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner/contractor for this project.
Owner/Occupant
o~/~/
. Contractor
City of Blair
10 --f'~a'" z 3~c"
\ Yoate / /
(5)-
EOUALIlOUSlfHl
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@cLblair,ne.us '"'''''"'''
::J!~~
o CITY OF BLAIR
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
PERMIT
LOCATION OF INSPECTION'
1 Ii (J
I; .
._~) () [
Ii
t -"rA',.-,,,
l
NAME OF OWNER' f \\ \'ri.~ /' /i,\ t;'v~
DATE INSPECTION REQUESTED-
{ -'\,
,-,,-"'I
~
CONTRACTOR -
""}'"
':') \J ......(j ~'TIME INSPECTION REQUESTED-
tf
;1/( li'1l'i\:!
I
l~~ ,) 7'
)"
~~
TYPE OF INSPECTION
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL
o CONFERENCE
FINAL 0 PARTIAL
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
o STATUS CHECK
~m F~ED
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
PASSED FAILED
o 0
COMMENTS:
MECHANICAL:O ROUGH-IN 0 A/C 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR-
. /4;V1<-
DATE OF INSPECTION MADE:
9'- 3d - 0 i
TIME' 11:?d A"trA..
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY