The URL can be used to link to this page

BP13434CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT o.em„ao a° 1 3 y� Permit # Date: �' S U Approximate Completion Date: I 1� - 3-L-1 "/ (� Site Plan Attached: REScheck Attached: Complete Plans Attached Application for: Reside nti " Commercial/Industrial New Construction V Manufactured Home Modular Move -on: Home Accessory Building Other Remodel Addition Accessory Building: Garage Pole Barn Other Floor Type: Dirt Concrete Electricity: Yes Sign Erecting, Awnings Decks/Handicap Ramps (plot plan 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 _ No Private Well Blair OPPD Line Kennard Date Agreement Received: Septic Drawing Provided: Blair Kennard Submitted: Yes No Project Information: Job Address: 1353 SKy 1iy1,t_ p,-- 8960871toe Legal Description (if applicable) L-0+ -7 13c Sh d Cor 7 //,1/, pc7 CeuG9c) -0 �:;') -7 Owner8M � �Zhond6�. A'Ake-WSAddress: 0) 1 Sj-�aj{ -i Phone#: L4Z(.- Sy -75 Contractor:' 1 e� n f n nSfV1.1 C i1 oy-) Phone #yzi)--,2c6cI Address: 1130 St(tt S+ Cell #: Email Address for Contractor: 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 cod es/or§lnanc es/o!§Inan"Vo!th 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 mpleted wi 'i t ars of date of issue. ignatu - of Owner/Contractor �eate 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 Review. Signature of Owner/Contractor Date ZONING REVIEW: Zoning/Flood Plain Utilities: Current Zoning: Conditional Use Permit Required: Date CU pproved: State Fire Marshal Required: Yes No Variance Required Yes No Yes No Minimum Setbacks: Front Second Front Side Side � Ream Lot Square Footage: Length x Width: Lot Coverage % v Driveways/Sidewalks: Sidewalk required: Yes No Sidewalk Waiver: Yes No Date Waiver Approved: Preexisting Garage requir 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 I_ Two Three Four Type of Residential Structure: Ranch �/ Two Story Split Entry_ Rooms Bedrooms Q— Bathrooms >Four High Rise (>75 ft) Raised Ranch Other Fireplaces ✓ Gas ✓ Electric Egress in Basement: Required: Yes ✓ No Provided on Plans: Yes ✓ No Sleeping Rooms Living Area Other Egress Sauare Footage: Main Level: 2- o 6,g Second Level: Basement: (Unfinished) ;4o I (Finished) Garage: /1 s 2 bay 3 bay Detached Garage: Pole Barn: Addition: Remodel: Porch: Front Rear Deck that affect setbacks: Rear Third Level 4 bay 5+ bay Side Front Side Occupancy Classification: R-3 - s i wg l -e f fi% �-j � 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, 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?" Nom 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: 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 C RESIDENTIA�-NE�WCONSTRU�CTION��- Permit fee is: Finished sq/ft area oQ 0 6 g —X$92 (not including finished basement area) Finished basement sq/ft area X $56 Unfinished basement sq/ft area D b g _X$29 Garage sq/ft area / 1 1-f- -S X $25 Total Valuation: Total Valuation r%8, 6,53-" Multiplied by 0.006 = Issuance Fee: Total Permit Fee = Deposit + Permit Fee + Issuance Fee $ l q0, 510.00 $ 59. I .00 $ �B, to 25.00 $ 853.00 $ 1 L0 73. 00 $ 25.00 $ o?/ 16. d 0 RESIDENTIAL - ADDITIONS/ REMODELS and COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS: Business/Industrial/Educational/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 Erecting/Awnings and Decks/Handicap Ramps: sq/ft area X $25 (Minimum valuation of $2000) Construction valuation computation: Finished sq/ft area I X $ $ Construction valuation is ...................................Permit fee is: $0 TO$50...........................................................$0 $51 TO $500 ........................................................ $25 $501 TO $2,000........................................................$25 + $3 peradditional $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 T0$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 $ Issuance Fee: $ 25.00 Total Permit Fee = Deposit + Permit Fee + Issuance Fee $ Additional Comments: Approved by: Date: " % - ( 0 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 1� 1,3q -�3 4 ECHANICAL PERMIT APPLICATIONG Jurisdiction, of City of Blair, Nebraska 218 South 16" Street Blair, Nebraska 68008 Fax (402) 426-4195 jVj :200'_ (402) 426-4191 Application Date: 00 Permit Fee: $-A ' Job Address Owne / ,1 �� ail A s Zip Phone 1. 160wa a Contractor Zi�� Phone Contractor Mail gess2. 3. Class of Work: O COMMERCIAL • ESIDENTIAL ew O Addition 13 Alteration O Repair O Replacement Describe Work:CLP /� a 4. (--i ME CAL PERMIT FEES Heat Pump Tons Central A/C Tons Furnace/Heat Pump/Air Conditioner (Per Unit) Furnace ® ( BTU/H Up to and including 100,000 BTU / 3Ton............................$15.00 # of Units A/C Furnace/Heat Pump/Air Conditioner (Per Unit) X 2 IN 6 D . O () Furnace Over 100,000 BTU/ 3 Ton.............................................$25.00 Completion Date: Refrigeration Units/Coolers/Lines/Compressor - Commercial (New or Replacement) (Per Unit) Boiler Chart BTU Fee .................................................................$15.00 Up to 100,000 ................................$15.00 100,000-500,000.1— .........................$30.00 500,000-1,000,000 ........................... $40.00 1,000,000-1,750,000 ..................... $60.00 Over 1,750,000 ..............................$100.00 (........... .. .... Boiler use BTU Chart to left) 00 ; Appliance Vent/Fans.................... .$10.00 Notice Duct System ............... $15.00 61 ......... ........ . I hereby certify that I have read and examined this application and know the same to be true and correct. All / T ' `� A�a-i?A �.� (� 5 i $6.00 provisions of laws and ordinances governing this type of �A' ^ ...........First x work will be complied with whether specified herein or x $1.00 not. The granting of a permit does not presume to give .........Additional authority to violate or cancel the provisions of any other state or local,*w regulating construction or the rmance of c c n. Radiant Heat Systems/Gas/Water n System................................$50.00 zPipir ModularHome ............................... $50.00 a Signature of Contractor or uth i d Agent Permit Issuance Fee ..................... .$25.00 1, Total Current License on File ,fes O No O N/A Date Comment: VJHRN PR OPFRT.Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Approved By: �2T, Rev. 2008-10 PLUMBING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 (402) 426-4191 / '_ I 0\ Application Date: Permit Fee: $ Job Address Ownerp'/ NJT1,Add 1.ZC Zip Phone Cont Mail Address Ct � 0�) 2. 3 Zip Phone 3. Class of Work: C3 COMMERCIA(,LJ RESIDENTIAL�New 0 Addition 0 Alteration (73 Repair 0 Replacement Describe Wo 4. 1 PLUMBING PERMIT FEES Comments: Modular Home ......................$50.00 Type of Fixture No. Kitchen .............................. $12.00 x Bath..... Residential/Single Stall $12.00 x ....................Multi -Stall $25.00 x Rough -In Bath ........................$8.00 x n Additional Sinks .....................$6.00 x Slop SirWLaundry Tray/Drain ..... $6.00 x u ........................$10.00xN Water Heater .........................$10.00 x t%' Notice Outside Water Faucet ...................$6.00 x N (J'J 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, ................................. 0J - Groundwork .........................$15.00 Septic Tank & Laterals............ $15.00 Lawn Sprinkler System ............ $10.00 Sprinkler System (Commercial).. $3 0.00 Gas/Water Piping System (Commercial) ........................$50.00 signature of Con actor or Authorized Agent Permit Issuance Fee .................$25.00 Total Current License on File m des 0 No 0 N/A Date Comment: WHEN PROPERLY VALIDA'IEL) (IN I HIN NVAUh) I hlla 1� Y UUK FhtCV11 I Approved By: Rev. 2008-10 MECHANICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 Fax (402) 426-4195 M 2007 (402) 4264191 Application Date: Permit Fee: $ Job Address Zi Ownef ail A s zip Phone 1. Contractor Mail Y5ressPhone 2. 3. Class of Work: O COMMERCIAL . ESIDENTIAL ew O Addition O Alteration O Repair O Replacement Describe Work: 4. MECHANICAL PERMIT FEES Heat Pump Tons Central A/C Tons Furnace/Heat Pump/Air Conditioner (Per Unit) Furnace �"�� BTU/H Up to and including 100,000 BTU / 3Ton............................$15.00 # of Units A/C Furnace/Heat Pump/Air Conditioner (Per Unit) Furnace Over 100,000 BTU / 3 Ton.............................................$25.00 Completion Date: Refrigeration Units/Coolers/Lines/Compressor — Commercial (New or Replacement) (Per Unit) Boiler Chart BTUFee ......................I.......................................................$15.00 Up to 100,000 ................................$15.00 100,000-500,000 .............................. $30.00 500,000-1,000,000 ........................... $40.00 1,000,000-1,750,000 ........................$60.00 Over 1,750,000................ ..............$100.00 Boiler (arse BTU Chart to left).................... Appliance Vent/Fans ........................$10.00 . Note read Duct stem..................................$15.00 10 I hereby certify that I and examined this application and know the same to be true and correct. All ,. ' �'�n 3 et `...........First 5 x $6.00 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 .........Additional x $1.00 authority to violate or cancel the provisions of any other state or local law regulating construction or the Radiant Heat Systems/Gas/Water performance of construction. Piping System................................$50.00 Modular Home ............................... $50.00 Signature of Contractor or Authorized Agent 06 Permit Issuance Fee .......................... $25.00 Total Current License on File Afts 0 No O N/A Date Comment: WHEN PROPERLY VALIDATED (1N THIS SPACE) 4HIS 15 YUUK FhK1V111 Approved By: Rev. 2008-10 1 ik ELECTRICAL PERMIT APPLICATION, l 3 Jurisdiction of City of Blair, Nebraska 218 South 16thStreet Blair, Nebraska 68008 Fax (402) 426-4195 E 3209 (402) 426-4191 Application Date: �� Permit Fee: Job Address i (%/' Owner;-'"?, /� ail Addre s j� Zip Phone ItzGe t 1. L 'G ' - � Contractor 1�aAddress Zip Phone 2./ /1 t C® "(-✓ 3. Class of W rk: RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE -'I%-NEW Describe Work: j 1 4. 5.Current License on FileYes O No N/A Completion Date ELECTRICAL PERMIT FEES Service Fee = (Amp Fee + $5.00 per branch circuit) Upgrade Existing Service.............$25.00 1-100 Amp Fee .......................$25.00 Temporary Service.................... $15.00 101-200 Amp Fee .......................$35.00 Fire Alarm System............. ......$15.00 201-300 Amp Fee .......................$55.00 301-400 Amp Fee .......................$75.00 Signs (each) .............................. $25.00 401-500 Amp Fee .......................$95.00 Miscellaneous Apparatus..............$15.00 501-600 Amp Fee.....................$115.00 601-700 Amp Fee.....................$135.00 Commercial/Multi Family and All Upgrades: 701-800 Amp Fee.....................$155.00 801-900 Amp Fee ..................... $175.00 # of Circuits x $5.00 901-1000 Amp.........................$195.00 Amp Fee IF OVER 1000 Amp 1" 1000 Amp Fee..................$195.00 Amp Fee + Circuit Total Each additional 100 Amps ......... $20.00 New Residential: (Finished Area) Single/Two Family Dwellings Noticed U sq. ft. x .063 I hereby certify that I have read and examined this application and know the same to be true and correct. All Modular/Manufactured Homes ....... $50.00 provisions of laws and ordinances governing this type of Other: (alterations, additions and modifications) work will be complied with whether specified herein or not. The granting of a permit does not presume to give Receptacles/Switches/Lighting Fixtures (110 volt only) authority to violate or cancel the provisions of any other # of Apparatus .......... x $1.00 state or local law regulating construction or the performance of construction. Power Apparatus (220 Volt or higher) # of Apparatus...... x $8.00 Smoke Detectors..... x $3.00 Signature o ontractor or Authorized Agent 6 Permit Issuance Fee...................$25.00 Total/ Date Comment: WHEN FKUFLICL Y V ALUM I L1J �llv l nia arti� � J 1 nim is x v u n r �tuvli � Approved By: 7� Rev. 2008-10 551 JOF ,ESS :ITY OF BLAIR, NEBRASKA Phone 402-426-4191 ITY, STATE, ZIPCODE THANK YOU KEEPTHIS COPYFOR YOUR RECORDS. NO RECEIVED BY Pounds Printing, Blnir, NE 68008 -")ise of a., CITY OF 5tAIQ 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. 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 ont actor City of Blair WI -1 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@ci,blair.ne.us aW "Y NI Q Tlf-- BUILDING PERMIT DEPOSIT AGREEMENT ("�Sidi5tial, $500. refundable deposit is being collected for any new commercial, new � 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. i ntractor/Owner ate Contractor/Owner City of Blair NIELSEN CONSTRUCTION CO. 1730 State Street BLAIR, NE68008 ZL- -3 S l , rGc�, 'g5' REScheck Software Version 4.2.1 Compliance Certificate Project Title: Bill/Rhonda Matthews Energy Code: 2006 IECC Location: Blair, Nebraska Construction Type: Single Family Conditioned Floor Area: 2068 ft2 Glazing Area Percentage: 9% Heating Degree Days: 6506 Climate Zone: 5 Construction Site: Owner/Agent: Skyline ridge Blair, NE Compliance: 10.1% Better Than Code Maximum UA: 404 Ceiling 1: Flat Ceiling or Scissor Truss Wall 1: Wood Frame, 16" o.c. Window 1: Metal Frame with Thermal Break:Triple Pane with Low -E SHGC: 0.50 Door 1: Solid Door 2: Glass SHGC: 0.50 Basement Wall 1: Solid Concrete or Masonry Wall height: 9.0' Depth below grade: 8.0' Insulation depth: 9.0' Furnace 1: Forced Hot Air 93 AFUE Air Conditioner 1: Electric Central Air 14 SEER PILE COPY Designer/Contractor: Your UA: 363 2068 0.0 50.0 39 2300 21.0 0.0 118 194 0.290 56 20 0.190 4 20 0.290 6 2300 11.0 0.0 140 Compliance Statement. The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2006 IECC requirements in RESche79V ersion 4.2.1 and to comply with the mandatory requiremeDI-Listed in the REScheck Inspection Checklist. UINC Name - Title S169ure Date Project Notes: 2 -bedroom walk -out ranch 3 -car garage Project Title: Bill/Rhonda Matthews Report date: 05/05/10 Data filename: Untitled.rck Page 1 of 1 IECC Energy �J(2006 Effie6encV Certificate Ceiling / Roof 50.00 Wall 21.00 Floor / Foundation 11.00 Ductwork (unconditioned spaces): Z7M M. ", Window 0.29 0.50 Door 0.19 0.50 Forced Hot Air Furnace 93 AFUE Electric Central Air Conditioner 14 SEER Water Heater: Name: Date: Comments: / 3 5 elf MATTHEW5 RE511)ENCE LOT #7 J 0/1 Ak( "VI ow"', dV-cUc--6-7 cS 5G0(c 6 h PLOT PLAN 6140' Ken llnnes Residential Design, LLC SGAL.E :1' = 30 �� 16125 Adams St. Omaha, NE 68135 CITY OF BLAIR LOCATION OF ❑ WASHINGTON COUNTY ❑ f ) NAME OF OWNER" CONTR ai DATE INSPECTION REQUESTED f° TIME INSPECTION REQUESTED: Z&6 /. 'I PERMIT NO TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ElCOMMENTS:'`" UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL El ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED El PARTIAL 1-1❑ 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 ElPRESSURE TEST ❑ ❑ COMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED � � /� I ' INSPECTOR: v� DATE OF INSPECTION MADE. ' - ` �_ TIME-- FAXED IMESFAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY l ❑:, CITY OF BLAIR LOCATION OF NAME OF ❑ WASHINGTON COUNTY ❑ OTHE r F CONTRACTOR - DATE INSPECTION REQUESTED _ TIME INSPECTION REQUESTED ' ' '' f PERMIT N0: TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑;FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ 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: INSPECTOR �� i DATE OF INSPECTION MADE: TIn L ` 6` FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY is D ' � r ET CITY "OF BLAIR ❑ WASHINGTON COUNTY ❑ OTIIER LOCATION OF INSPECTION NAME OF OWNER CONTRACTOR- ONTRACTOR DATE DATE INSPECTION REQUESTED v TIME INSPECTION REQUESTED: PERMIT NO TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL El❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE, ❑:TEMPORARY SERVICE [_1 PRECONNECT 5eEl ILED ❑ PARTIAL COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: ❑ ❑ PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED F] PRESSURE TEST El ElCOMMENTS: ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS- INSPECTO DATE OF INSPECTION MADE: ®` l / TIME• &-.moi F D OPPDT EA TO CONNECT SERVICE: ON BY 518-1U. .M1 TM h N �lN Al x rte— - ...,�,.`,.. � i. sir=.-">�—ss•<`:-�'�. �a�: � ;c- y��_�rt _�. Cif. i".1 ire 1i.: 2".r}. F'� S...L _ a-._ I OV"T Ji i� r5% i I0 f ,2l/AlO iQpe -AM: J . � .1» "- =�;s .,.h, �: � _ �. y. F i Y: : & �`. �a �✓ r s �3- 4�4):ii� `�-"� sJ i"� � 9".- a[FF "d BUILDING INSPECTION REPORT ' CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER pp . LOCATION OF INSPECTION: i NAME OF OWNER- — CONTRACTOR'` DATE INSPECTION REQUESTED _ -i'9__' TIME INSPECTION REQUESTED- PERMIT NO ' TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK BUILDING: ❑ FOOTING ,,JZ -•9 DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED El PARTIAL ❑ F1s COMMENTS: MECHANICAL: ❑ ROUGH—IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑FINAL El PARTIAL PASSED FAILED 1-1 F] ' COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH—IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED ❑ PRESSURE TEST ❑ ❑ COMMENTS: 1 ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTOR _� DATE OF INSPECTION MADE:4f TIM FAXED OPPDTURT REA TO CONNECT SERVICE: ON B I NP I I L 4 ) I k J T.�.x �,.� �. OF ❑ CITY OF BLAIR BUILDING i R ❑ WASHINGTON COUNTY LOCATION OF INSPECTION: NAME OF OWNER- CONTRACTORS d DATE INSPECTION REQUESTED- ' TIME INSPECTION REQUESTED: j`` PERMIT NO-L---' rs ❑ OTHER TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE �❑ ❑ STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING DRYWALL ❑ FINAL ❑ PARTIAL PASSED FAILED COMMENTS: UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL� PASSED FAILED ❑ ❑ COMMENTS: PLUMBING- ❑, GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIALS ✓r�4PASSED FAILED PRESSURE TEST ❑ COMMENTS: x, ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED INSPECTORW DATE OF INSPECTION FAXED OPPD\BURT REA TO CONNECT SERVICE: a rj T