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BP13345A4 CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT gP.omsaoa, Permit # / 3 Date: Approximate Completion Date: Site Plan Attached: REScheck Attached: Complete Plans Attached Application for: Residential Commercial/Industrial ir' 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 pian required) Satellite Dishes/Radio Antenna/Cell Towers (plot pian required) Other Utilities: Public Water: Yes No _ If yes, responsible entity: Agreement needed: Public Sewer: Yes No _ If yes, responsible entity: County Road Permit Required: Yes No _ Private Well Blair OPPD Line Kennard Date Agreement Received: Septic Drawing Provided: Blair Kennard Submitted: Yes No Project Information: Job Address: Legal Description (if applicable) Owner: G(12!Z4Address: Phone#: Contractor: Address: Z y /1 t,1l1l 11"71'111 Phone #: l f ��pa w IV2 79,;2 c) Separate permits are requir d 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. 1 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. 1 understand that this permit is void if work is not commenced within gignature abi completed within two (2 ear , --f date of issue. of Owne /Contractor Date For Building Permits other than One & Two Family Residential Structures: I hereby acknowledge and agree that I have/will submit a set of plans for this project to the Nebraska State Fire Marshal's Office for (41g*'nature of Owner/Contractor Date ZONING REVIEW: Zoning/Flood Plain/Utilities: Current Zoning: Conditional Use Permit Required: Yes No Date CUP Approved: State Fire Marshal Required: Yes No Variance Required: Yes No Minimum Setbacks: Front Second Front Side Side Rear Lot Square Footage: Length x Width: Lot Coverage % D riveways/Si d ewa i ks: Sidewalk required: Yes No Sidewalk Waiver: Yes No Date Waiver Approved: Preexisting Garage requires driveway to be less than 3' from property line: Yes Approved by: Flood Plain: Yes No If yes, specify special requirements: BUILDING INSPECTOR REVIEW: Number of Stories One Two Three Four >Four High Rise (>75 ft) Type of Residential 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 Footage: Main Level: Second Level: Third Level Basement: (Unfinished) (Finished) Garage: 2 bay 3 bay 4 bay 5+ bay Detached Garage: Pole Barn: Addition: Remodel: Porch: Front Rear Side Deck that affect setbacks: Rear Front Side Occur)ancv Classification: Assembly, theaters, with stage Assembly, theater, without stage Assembly, nightclubs Assembly, restaurants, bars, banquet hails _ 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, supervised environment Institutional, incapacitated Institutional, restrained Institutional, day care facilities Mercantile Residential, hotels Residential, multiple family Residential, one- and two-family Residential, care/assisted living facilities Storage, moderate hazard Storage, low hazard Utility, miscellaneous Is building required to be protected by automatic fire sprinkler system?" No Only partially in some areas or rooms Please Specify Yes If yes, the standard to which the sprinkler system will be designed: NFPA 13 NFPS 13R NFPA 13D Driveway Grade: 20% grade or less? Yes No (Dale will review new residential construction. Al will review all second access requests and industrial and commercial driveway requests) Required Off Street Parking: Permit Fee Calculation: Building Permit Deposit Fee: Commercial, new homes and residential additions/remodels/accessory buildings valued $10,000 or greater $ 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 sq/ft area X$92 (not including finished basement area) Finished basement sq/ft area X$56 Unfinished basement sq/ft area X$29 Garage sq/ft area X$25 Total Valuation: Total Valuation Multiplied by 0.006 = Issuance Fee: $ 25.00 Total Permit Fee = Deposit + Permit Fee + Issuance Fee $ essJ n du ational/Assembly/Factory/Storage/Utility *Porches with roofs/screened patios are considered additions Construction valuation computation: Sq/ft area X $63 Except for the following: Accessory Buildings & Interior Remodeling Projects: sq/ft area X $43 Pole barns with no hard surface floor: sq/ft area X $25 Sign Erect! ng/Awn ings and Decks/Handicap Ramps: sq/ft area X $25 (Minimum valuation of $2000) Construction valuation computation: z f ,11 0c) Finished sq/ft area 2,3 j 72 X $ L $ 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$1,000,000 .................................................. $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 $ aIi . _' } Issuance Fee: $ 25.00 Oc" 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 Receipt # Deposit Paid by for return to: Building Inspection Pouch given: Yes No Application Date: PLUMBING PERMIT APPLICATION Jurisdiction of City of tBlair, Nebraska 218 South 16 Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 r • Permit Fee: $ eq Job Address & ; ('iZZ % G Owne MailA dress( - Zip Phone 4 c — Contra for ail Phone r 3. lass of Work: OMMERCIAL O RESI ENTIAL ew O Addition O Alteration O Repair O Replacement Describe Work: ) 4. ®r PLUMBING PERMIT FEES Modular Home ......................$50.00 Comments: 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 Notice Outside Water Faucet...................$6.00 x I hereby certify that I have read and examined this Drinking Fountain ........................$6.00 x application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or Backflow/Grease Trap.............$15.00 not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other Water Service .......................$15.00 state or local law regulating construction or the Sewer.................................$15.00 performance of construction. Groundwork .........................$15.00 Septic Tank & Laterals............ $15.00 Lawn Sprinkler System ............ $10.00 00 Sprinkler System (Commercial)..$30.00 " Gas/Water Piping System (Commercial) ........................ $50.00 Signature of Contractor or Authorized Agent Permit Issuance Fee.................$25.00 ^' Total ' Current License on File es O No O N/A Date Comment: WHEN FKUFhFLY VALIVA1L11 �11N 1t113 arlxl—Z) 1r11O10 1vul'1 u.111 Approved By: a' Rev. 2008-10 Jun, 17, 2010 11:44AM CITY OF BLAIR (402, 426, 4191) No, 5023 F. 2 PLUMBING PERMIT APPLICATION 019 5 q 6 Jurisdiction of City of Blair, Nebraska 218 South 16"' Street Blair, Nebraska 68008 Fax (402) 426-4195 P 2124 (402) 426-4191 Application bate: rf'' Job Address �lyldress �v contra 3. Mass Of Work: Describo Work: 4. Comments: Pen -nit Fee: $ ° d 0 J/Zip Pltonc i Cl ors �3 � /� '. r�d�ir� �A 7 ��-iGew ❑ Addltlon ❑ AlEeratlon ❑ Repalr ❑Replacement PLUMBING PERKES Modular klonie......... . ....... . ....$50,00 TI'ype of Fixture No. ure of Qo actor or Authorized Agent 1117116) Date Fee . ............. $25. Total Current License o�ile es❑ No ❑ N/A Comment: WREN PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT Approved By, L 2008-10 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 Notice Outside Water Faucet...................$6,00 X I hereby certify that I have rend and examined this Drinking Fountain ........................$6.00 X application and know the same to be true and correct. All provisions of laws and ordinances governing this type of. work will be complied with whether specified herein or Backflow/Grease Trap.............$15.00 not, The granting of a Int -mit does not presume to give Authority to violate or cancel the provisions of any other Water Service ....................... $15.00 state or local low regulating construction or the Sewer .. •.......... $15.00 performance of construction. .............. . .... Groundwork ...... . ....... . ....... ...$15.00 Septic Tank & Laterals.,.......... $15,00 Lawn Sprinkler System.. ....... , ..$10.00 Sprinkler System (Commercial).330.00 Gas/Water Piping System (Commercial)........................$50.00 ure of Qo actor or Authorized Agent 1117116) Date Fee . ............. $25. Total Current License o�ile es❑ No ❑ N/A Comment: WREN PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT Approved By, L 2008-10 NOVOZYMES BLAIR, INC. PO BOX 549 FRANKLINTON, NC 27525 919-494-3000 City of Blair 218 South 16th Blair NE 68008 novozv, lrms@ Y111 Rethink Tomorrow Page 1 of 1 Date 03/18/2010 Document 3600000166 Check # 001381 VOUCHER INVOICE GROSS AMOUNT DISCOUNT NET AMOUNT 1800000482 PAYREQ030910 16,458.00 0.00 16,458.00 Permit # 13345* Sum Total: 16,458.00 0.00 16,458.00 DETACH AND RETAIN THIS STUB FOR YOUR RECORDS CHECK# 001381 CITY ', NEBRASKA Phone 402-426-4191 THANK YOU KEEP THIS COPY FOR YOUR RECORDS. NO RECEIVED BY Pounds Printing, Blair, NE 68008 -"7 se of a' CITY OF I)LAIQ 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 Building 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. Owner/Occupant City of Blair Contractor 2 04E VJ0 Date 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblalr@ci,blair,ne,us N' Vtll" BUILDING PERMIT DEPOSIT AGREEMENT A $500.00 ndable deposit is being .collected for any new commercial, new s d��i#- , 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. d r•Z Contractor/Owner Contractor/Owner City of Blair ZZLlRi2« Date CITY OF BLAIR r LOCATION OF INSPECTION: BUILDING , REPORT ❑ WASHINGTON COUNTY ❑ OTHER NAME OF OWNER`' CONTRACTOR DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED f PERMIT NO• TYPE OF INSPECTION REQUESTED Mp„ ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECKFOOTING [:1 FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ F] COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED F1 F] COMMENTS: PLUMBING:, GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTOR:/ DATE OF INSPECTION MADE: `� d ^ TIME: /�� FAXED OPPMBURT REA TO CONNECT SERVICE: BUILDING INSPECTION REPORT ❑ CITY OF BLAIR ❑ WASHINGTON COUNTY F] OTHER LOCATION OF INSPECTION NAME OF OWNER- CONTRACTORL- - DATE INSPECTION REQUESTED:- TIME INSPECTION REQUESTED- L) PERMIT NO TYPE OF INSPECTION REQUESTED: [_1 CONFERENCE El STATUS CHECK BUILDING: F] FOOTING [_1 DECK FOOTING ❑ FRAMING F -I DRYWALL E:l FINAL El PARTIAL PASSED FAILED F -I 0 COMMENTS: UTILITIES: ❑ SEWER TAP ,,Z` SEWER 0 SEPTIC [I WATER TAP El REMOTE El WATER SERVICE PASSED- TAILED El"PARTIAL c,- COMMENTS:/ El ELECTRICAL: F-1 ROUGH IN ❑ FINAL El PERMANENT SERVICE F] TEMPORARY SERVICE El PRECONNECT PASSED FAILED F-1 PARTIAL El El COMMENTS: MECHANICAL: El ROUGH -IN F] A/C El FURNACE 0 RADIANT HEAT D FINAL 0 PARTIAL PASSED FAILED F] F -I COMMENTS: PAD F1 ROUGH -IN F� FINAL F PLUMBING: WATER METER INSTALLED ❑ PARTIAL D FAILED ❑ PRESSURE TEST El COMMENTS: F-1 OCCUPANCY GRANTED F1 CONDITIONAL OCCUPANCY GRANTED P v INSPECTOR- DATE OF INSPECTION MADE: TIME - FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY AW,BUILDING INSPECTION r CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION t` '' ` _; r -• NAME OF OWNER: CONTRACTOR ` esi DATE INSPECTION REQUESTED Vis` TIME INSPECTION REQUESTED f �" �` ` �' PERMIT NO TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: i ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL El F1 COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED F] ❑ COMMENTS: PLUMBING: GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED COMMENTS: ❑ PRESSURE TEST " i n, r: r r ;!' ._ r ' lfs ,• El`°.a° ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED t c NOTES/REMARKS• el fid' f i f f 4 f 1 INSPECTOR- << / DATE OF INSPECTION FAXED OPPD\BURT REA TO CONNECT SERVICE: ON j TTMF.- �.BUILDING INSPECTION REPORT CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER tix LOCATION OF INSPECTIONIcN" 0 t t _ t NAME OF OWNER- , CONTRACTOR DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED PERMIT NO.& TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECKFOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: UTILITIES: ❑ SEWERTAP L>. ER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATERSERVICF, PASSED FAILED F1 PARTIAL El El COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIALS PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL AS ED FAILED ❑ COMMENTS: PRESSURE TEST L [/�Z'�� /'y` J{ ` //� �`% t 5A_` El L^ I/ �14N br'if" Vs.J ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS T lrao L ret.,I c: S�N, Pda'Na -ja e v` !� —,S'- 7fo INSPECTOR &*-Z DATE OF INSPECTION MADE: -26- lo TmEJ 6 13 0 A - FAXED OPPD\BURT REA TO CONNECT SERVICE: .. � l ��d\ � r � r0�u Qt ssM[ • yyR� `� �� _1i. , . ��,�., . _ +t.•t 04, t � Y VIMBUILDING T CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION E NAME OF OWNER6 '.L v 6 z° CONTRACTOR:_c t r.�� ; DATE INSPECTION REQUESTED:_ "' ` " J TIME INSPECTION REQUESTED- `° _" ` PERMIT NO• ' TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑` SEWER ❑ SEPTIC ❑ WATERTAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED PARTIAL IN ❑ COMMENTS. aa,�C t`'. € s '"'„ �Y '•.. t,,p _ �! nn ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED F1 PARTIAL El COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST El El COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS• v INSPECTOR: DATE OF INSPECTION MADE:_ _= _1 0 TIME- UAWS FAXED OPPDIBURT REA ' TO CONNECT SERVICE: ON By N❑ CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ LOCATION OF INSPECTION% NAME OF OWNER' DATE INSPECTION REQUESTED ' ' TIME INSPECTION REQUESTED --' f PERMIT NO• - TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ YFRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: F . F <j � k' �'i S ❑ UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT^ SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN [:1 A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑GROUNDWORK ❑ ROUGH -IN F1FINAL ElWATER METER INSTALLED ElPARTIAL ry PASSED FAILED E] PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: INSPECTOR y hA DATE OF INSPECTION MADE: I ® TIME, 3 P L FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER - NSPECTION LOCATION OF INSPECTION- r NAME OF OWNER: NAME ONTRACTOR CONTRACTOR- DATE DATE INSPECTION REQUESTED w r' TIME INSPECTION REQUESTED =�..' PERMIT NO TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑' A FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED -7 J ❑ OMMENTS COMMENTS- UTILITIES: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED j"yO 0 INSPECTOR:' ✓ DATE OF INSPECTION MADE: "l TIME t FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY G k CITY OF BLAIR LOCATION OF ❑ WASHINGTON COUNTY ❑ ko NAME OF OWNER- < 6 L/ DATE INSPECTION REQUESTED v _°' TIME INSPECTION REQUESTED--" ' ` ` `" PERMIT NO- j TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL NZARTIAL PASSED FAILED e r ❑ COMMENTS. UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED �a�n • 'ALL : C �,Mill '+1111 ws /D=Ioo INSPECTOR: DATE OF INSPECTION MADE: Cj TIME- / A FAXED OPPDIBURT REA TO CONNECT SERVICE: . nyar Ni�AY r ti ri rho . x It I It i FA El 05123100'I'M AM __�. 4, 4: ,� .. d.�:'�.. ;, �., ,� ��:; _ TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE BUILDING INSPECTION BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: h G �. i C t�-c 2 � �- �� 3 d r o 3 ❑T.CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE ! to LOCATION OF INSPECTION- NSPECTION NAME NAME OF OWNER- / t �. CONTRALTO r 1 ` ❑ ❑ / il — az ,_ DATE INSPECTION REQUESTED ,.� € TIME INSPECTION REQUESTER' ' PERMIT NOL- — � TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: h G �. i C t�-c 2 � �- �� 3 d r o 3 -¢ n UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH—IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ F-1COMMENTS:,,,- .. PLUMBING: ❑ GROUNDWORK ❑ ROUGH—IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED rrnmva MUAX n nrro. INSPECTOR �� QJ DATE OF INSPECTION MADE: FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY BUILDING INSPECTION REPORT❑ CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER �R•j11 06 L— G I �R LOCATION OF INSPECTION NAME OF OWNER- CONTRACTORS DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED: PERMIT NO TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS � �`�� , �s E=� �' .J ` �-- T6 - � `�•O '- ��b UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED �❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTOR' //56 ,0' " DATE OF INSPECTION MADE: y r 0 TIME- FAXED IME FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY 'TfoN sl.%I* J33�-5 I MI " 6/29/2010 2:02pm ti "' � �~' � ' �{ - � $ i4 L �� _ Lid® a j 7 I WIN . u Q� ❑''. CITY OF BLAIR LOCATION OF INSPECTION: ❑ WASHINGTON COUNTY ❑ NAME OF OWNER:," ` ,, ; �� CONTRACTOR DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED.PERMIT N0: = f TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑: yF00TING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ✓�cs�_ COMMENTS: �'h`�I� BY El h l� UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ ^ PARTIAL PASSED r FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTOR/ DATE OF INSPECTION MADE: TTMF. FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY JBUILDING INSPECTION 1 :n_ "ITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION: r '' t'� 19 NAME OF OWNER �'" CONTRACTOR- ONTRACTOR DATE INSPECTION REQUESTED- DATEQ TIME INSPECTION REQUESTED • PERMIT NO• _ TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: [" FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: ' ' ` n 66 f` C Ec V, (A �K - El UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: r PLUMBING: ❑ GROUNDWORK ❑� ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTOR. DATE DATE OF INSPECTION MADE: _16-- f ® FAXED OPPD\BURT REA TO CONNECT SERVICE: ❑""CITY OF BLAIR LOCATION OF 1I u acal / [WoUllotmi ❑ WASHINGTON COUNTY ❑ NAME OF OWNER f' r <%' 3`r , ,` °' CONTRACTOR :. DATE INSPECTION REQUESTED- r TIME INSPECTION REQUESTED PERMIT NO' `•� TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING:]" ,.FOOTING ❑ DECK FOOTING ElFRAMING ElDRYWALL ❑ FINAL ❑ PARTIALS PASSED FAILED COMMENTS:6 UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -W ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTOR- DATE OF INSPECTION MADE: FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY NOTES/REMARKS: INSPECTOR• DATE OF INSPECTION MADE: _% ® TIME• r}-f'ov�- FAXED OPPD\BURT REA TO CONNECT SERVICE: BUILDING INSPECTION REPORT :.. CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION NAME OF OWNER t e`: CONTRACTORA, DATE INSPECTION REQUESTED- TIME INSPECTION REQUESTED-PERMTI NO.• f TYPE OF INSPECTION REQUESTED ❑ CONFERENCE ❑ STATUS CHECK BUILDING: Q FOOTING ❑ DECK FOOTING ❑ FRAMING El DRYWALL ❑ FINAL ❑ PARTIAL S PASSED FAILED COMMENTS: ,� �� 16_(.� -� �Q- a ❑ UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACES ❑ RADIANT HEAT ❑ FINALE] PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL vV 1r JPASSEDA uFAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: INSPECTOR• DATE OF INSPECTION MADE: _% ® TIME• r}-f'ov�- FAXED OPPD\BURT REA TO CONNECT SERVICE: r`�AJ CITY OF BLAIR LOCATION OF INSPECTION. ❑ WASHINGTON COUNTY ❑ NAME OF OWNER f T yi CONTRACTOR Lac co w4, A o L r L�, � /°Z -t) cK DATE INSPECTION RE UESTEu TIME INSPECTION REQUESTED PERMIT NO��-` � TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ `FOOTING ❑ DECKFOOTING FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ COMMENTS: ((❑ 5-1 - I. %� UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: � PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: CDbl,{lL®L Lac co w4, A o L r L�, � /°Z -t) cK l.Q ec— (ZeA c INSPECTOR �jKI�L✓c^ DATE OF INSPECTION MADE: 7—a2-10 FAXED OPPD\BURT REA TO CONNECT SERVICE: ❑ -:::CITY OF BLAIR LOCATION OF ❑ WASHINGTON COUNTY ❑ NAME OF OWNER �'� t um� CONTRACTOR • -� `- DATE INSPECTION REQUESTED- TIME INSPECTION REQUESTED `° °,y`b° PERMIT NO TYPE OF INSPECTION REQUESTED: ---[:]—CONFERENCE ❑ STATUS CHECK BUILDING: ❑_,FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL❑ FINAL PARTIAL PASSED FAILED - s El COMMENTS: COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH—IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: _ PLUMBING: ❑ GROUNDWORK ❑ ROUGH—IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ " PRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED 6/0+ 60! 1 � � p INSPECTOR- / DATE OF INSPECTION MADE: l v TiMF'�- FAXED OPPD\BURT REA TO CONNECT SERVICE: