BP13447CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # %
Date: "e, 71
Approximate Completion Date:
Site Plan Attached: O'EScheck Attached:
® _ /0
Complete Plans Attached
Application for: Residential Commercial/Iridustrial
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 _
Description of project if necessary.
01 /P -) : J/h //, CI ,
_ Private Well
Blair OPPD Line Kennard
Date Agreement Received:
Septic Drawing Provided:
Blair Kennard
Submitted: Yes No
W
Job Address: / � CJS ✓ ` � �D l/4 PC' 16
Legal. Description (if applicable)
Owne ��"' Address: � Phone#:
Contractor:,
Address:
c i,�I /1 r• lb,a "CA Y/,
Phone #:
Cell #:
Email Address for Contractor: i 0/1 e- � ��%'�/����%�"� /�''�• (����
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 co feted within two (2) years of date of issue. G�
10 r�
J �� ✓ f -
�'f
nature of Owner/Contractor Date
F r Buildin Permits other than One & Two Family Residential Structures:
I hereby a knowledge anlvt�,u gree that I have/will submit a set of plans for this project to the Nebraska State Fire Marshal's Office for
Review. /-Z_�l
'//IV-" )j
ignatu a of Owner/Contractor Date
ness/Industrial/Educational/Assembly/Factory/Storage/I
*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 $2000)
Construction valuation computation:
3
j ��� Lobl,
Finished sq/ft area
G 6 7 -X$
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$1,000,000..................................................$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 $ /'z5 g aD
Issuance Fee: $ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $ 1763,
Additional Comments:
Approved by: 2L&� e_ Dater 5--(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
5/7/2010 1 M 05007-10
Tom Bulthuis
First Watch
223 N 6th Street
Plattsmouth, NE 68048-
(402) 319-2872
NEBRASKA STATE FIRE MARSHAL
PLANS DIVISION'r
Code Reviewj
BRAS`
Little Blossoms Daycare
1620 State St
Blair 68008 -
Your items have been reviewed for compliance with the Nebraska State Fire Marshal Act.
Fire Alarm Shop Drawing New Fire Alarm System
REMARKS:
This Code Review does not include a determination for compliance with the State of Nebraska
Accessibility Guidelines. Accessibility compliance must be determined by the local jurisdiction in which
the project is located.
Review applies to new fire alarm system as shown only.
1. The visual alarm notification appliance shown on the center dayroom of three that are divided by two
foot walls shall provide total coverage for the "north" dayroom. (no point of compass provided). 9.6.3.6
cc: Dist. B
Blair codes
Page 1 of 2
PLEASE CONTACT OFFICE INDICATED BELOW FOR A FINAL INSPECTION.
FINAL ON -SATE APPROVAL IS REQUIRED PRIOR TO OCCUPANCY OR USE.
SIGNED:
Reviewed By: Main Office
246 South 14th Street
Lincoln, NE 68508-1804
(402) 471-2027
Douq Hohbein
Contact for Inspection: District A
246 South 14th Street
Lincoln NE 68508-1804
(402) 471-2590
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
Issuance Fee:
Multiplied by 0.006 =
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $
�1�
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1979
(402) 426-4191
00
Application Date: - l 0 Permit Fee: $
Job Address
P
Own
1. :;4�of Address Zip Phone
Contract Mail Addresel Zip Phone
2. P
3. Class of Work: '�I<OfWERCIAL O RESIDENTIA O New O Addition O Alteration O Repair Weplacement
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)
..............................................................................$15.00
Boiler Chart
BTUFee
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 (use BTU Chart to left)....................
Appliance Vent/Fans ........................$10.00 °
Notice
1 hereby certify that I have read and examined this
Duct System..................................$15.00
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of
Gas/Air Outlets.................First 5 x $6.00
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
Si tur of Contractor or Authorized Agent
Permit Issuance Fee............ ..... $25.00 ° ,00
Total 4119
Current License on File es O No O N/A
T
Date
Comment:
WHEN PROPERLY VALIDATED (INTHIS SPACE) THIS 1S YOUR PERMIT
Approved By: Pi
0
Rev. 2008-10
MECHANICAL PERMIT APPLICATION
"1
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
COPY Blair, Nebraska 68008
Fax (402) 426-4195079
/� /� (402) 426-4191 - -
Application Date: "7 V Permit Fee: $ ® p
0�
C\�
Job Address
(�,
owne ail Address / Zip Phone
1. Q.y . L/
Contract L � ddre
Al 1 Zip Phone
2. aaw 91.
3. Class of Work: 01VIMERCIAL O RESIDENTIA O New O Addition O Alteration O Repair Weplacement
Describe Work: r
GI 6 j v
MECHANICAL PERMIT FEES
Heat Pump Tons
Central A/C Tons
/
Furnace/Heat Pump/Air Conditioner (Per Unit) /J . ®®
Furnace BTU/H
Up to and including 100,000 BTU / 3Ton............................$15.00
# of Units A/C
Fumace/Heat Pump/Air Conditioner (Per Unit) V"•oto
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 (use BTU Chart to left) ....................
Appliance Vent/Fans......... $10.00
Notice
Duct System ...................... $15.00 /(5.190
""""""
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
Gas/Air Outlets.................First 5 x $6.00
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
�J
' ®d
Permit Issuance Fee............ .....$25.00 0�
Total%0' OD
Current License on File s O No O N/A
Date
Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Approved By:
W
Rev. 2008-10
ZONING REVIEW:
ZoningZFiood Plain U iliti :
Current Zoning: Conditional Use Permit Required: YesNo
Date CUP Approved: M a(/ ; J
State Fire Marshal Required: Yes No Variance Required: Yes No
Minimum Setbacks: Front Secon Front Side Side Rear
Lot Square Footage: 0�—'
Length x Width: Lot Covera
Driveways/Sidewalks:
Sidewalk required: Yes No Sidewalk Waiver: Yes No
Date Waiver Approved:
Preexisting Garage re uiresriveway to be less than 3' from property line: Yes
Approved by:
Flood Plain: Yes No
If yes, specify special re uirerii ents:
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
Square Footage:
Main Level:
Basement: (Unfinished)
Garage:
Detached Garage:
I�60
Porch: Front
Rear
Deck that affect setbacks: Rear
Occur)ancv Classification:
Second Level:
Third Level
(Finished)
2 bay 3 bay 4 bay 5+ bay
Pole Barn:
Remodel:
Side
Front Side
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)
5/7/2010 1 M 05007-10
Tom Bulthuis
First Watch
223 N 6th Street
Plattsmouth, NE 68048-
(402) 319-2872
Little Blossoms Daycare
1620 State St
Blair 68008 -
Your items have been reviewed for compliance with the Nebraska State Fire Marshal Act.
Fire Alarm Shop Drawing New Fire Alarm System
Alt Phone: Email: firstwatch@charter.net
Occupancy Type: Business Construction Type:
Estimated Start Date: 5/9/2010 Estimated Completion Date: 5/15/2010
Fire Protection Features:
Sprinkler Total ❑ Spinkler Partial ❑ Range Hood System ❑ Sprinkler Other:
Fire Alarm Manual Sys. ® Smoke Detection ❑ Heat Detection ❑ Fire Alarm Other:
Page 2 of 2
PLEASE CONTACT OFFICE INDICATED BELOW FOR A FINAL INSPECTION.
FINAL ONSITE APPROVAL IS REQUIRED PRIOR TO OCCUPANCY OR USE.
SIGNED:
Reviewed By: Main Office
246 South 14th Street
Lincoln, NE 68508-1804
(402) 471-2027
Douq Hohbein
Contact for Inspection: District A
246 South 14th Street
Lincoln NE 68508-1804
(402) 471-2590
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
M Vill l --
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 ref dable deposit is being collected for any new commercial, new
residential d any additions, remodels and accessory building valued $10,000 or
ate 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.
Contractor/Owner Contractor/Owner
City of Blair
Date
Application Date
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 P 2116
(402) 426-4191
I�Lil(c)
Permit Fee: $q,
Job Address G Z
Own r Mail Address Zi Phone
1.�� iICJ G'12 f /\I �l'itf del L�1�.Ua 5 �S `��
Contractor Mail Address Zip Phone �tE t^1
2. �l '::ii � �A dq lel �,Gt �L
3. Class of Work: j3tOMMERCIAL ❑ RESIDENTIAL O New ❑ Addition Iteration ❑ Repair ❑ Replacement
Describe Work:
4."1U L� CtL Y�iY"V t
PLUMBING PERMIT FEES
Comments: Modular Home ......................$50.00
Type of Fixture No.
of Contractor or Authorized Agent I Permit Issuance Fee.................$25.00
L) I Current License on File Yes ❑ No ❑ N/A
Date Comment:
Approved By: au
Rev. 2008-10
Kitchen .............................. $12.00 x
Bath..... Residential/Single Stall $12.00 x
....................Multi -Stall $25.00 x 5a UC:t
Rough -In Bath ........................$8.00 x
Additional Sinks.....................$6.00 x 2_ (� U
Slop Sink/Laundry Tray/Drain ..... $6.00 x _� G CDC
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
performance of construction.
.................................$15.00
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
of Contractor or Authorized Agent I Permit Issuance Fee.................$25.00
L) I Current License on File Yes ❑ No ❑ N/A
Date Comment:
Approved By: au
Rev. 2008-10
��
0/;7 of av
CITY Of 5LAIQ
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 Building
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
City of Blair
N
Contractor
5 _2� -<v
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cifyofblair@cLblaicne.us oPoo..Ux,..
PERMIT NO:—
FILE COPY -X- -X- -X— — —X— — —X ELEC.
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PLAYS AREA
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IS IN
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PLAY AREA
28'x42'
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DAY ROOM
104
15'x20'
DAY ROOM
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15'x20'
DAY ROOM
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15'x20'
CORRIDOR
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106
EXISTING C
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28'-0.±
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111
14'x26'8"
4 FEET PARTITIONS W/GATE
DAYROOM
113
15'x20'
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DAY ROOM
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15'x20'
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APPROVAL AS A RESULT OF AN INSPECTIONE BLOSSOMS- FURNITURE PLAN
SHALL NOT RE CONSTRUED T E AN APPiR(C '�;Wli MOVABLE PARTITIONS
OF A VIOLATION OF THE PROVISIONS OF, `.'$GP 3/32"=1'-0"
CODE OR OF OTHER ORDINANCES OF T �-dog
JURISDICTION.
ELEC.
112
SINK IN 7-10'
HIGH BASE
CABINET W/
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EXISTING
DAY ROOM
117
12'x21'
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PLAY AREA
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ACTIVITY AREA ASHEI
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OVERHANG
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APPROVAL AS A RESULT OF AN INSPECTIONE BLOSSOMS- FURNITURE PLAN
SHALL NOT RE CONSTRUED T E AN APPiR(C '�;Wli MOVABLE PARTITIONS
OF A VIOLATION OF THE PROVISIONS OF, `.'$GP 3/32"=1'-0"
CODE OR OF OTHER ORDINANCES OF T �-dog
JURISDICTION.
ELEC.
112
SINK IN 7-10'
HIGH BASE
CABINET W/
SAN. PUMP -
EXISTING
DAY ROOM
117
12'x21'
OUTDOOR
PLAY AREA
15'x16'
LITTLE BLOSSOMS
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06/0212010 0253 PM>.
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m„
CITY OF BLAIR ❑
LOCATION OF INSPECTION:
NAME OF
BUILDING INSPECTION REPORT
oi —
WASHINGTON COUNTY El OTHER
DATE INSPECTION REQUESTED-
TIME INSPECTION REQUESTED PERMIT
NO
a
TYPE OF INSPECTION REQUESTED: El CONFERENCE
El STATUS CHECK
BUILDING: F -I
FOOTING F1 DECK FOOTING E:l FRAMING E:l DRYWALL E:l FINAL E:l PARTIAL
PASSED
FAILED
COMMENTS:
UTILITIES: R
SEWERTAP F -I SEWER 0 SEPTIC F] WATERTAP F -I REMOTE R WATER SERVICE
PASSED
FAILED
F-1
PARTIAL
COMMENTS:
ELECTRICAL: R
ROUGH IN F -I FINAL R PERMANENT SERVICE F1 TEMPORARY SERVICE F] PRECONNECT
PASSED
FAILED
F-1
PARTIAL
COMMENTS:
MECHANICAL: F]
ROUGH -IN 0 A/C [_1 FURNACE El RADIANT HEAT El FINAL El PARTIAL
PASSED
FAILED
COMMENTS:
PLUMBIN
GROUNDW El FINAL F1 WATER METER INSTALLED El PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
COMMENTS:
❑ OCCUPANCY GRANTED R CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS:
I
INSPECTOR: DATE OF INSPECTION MADE:
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
BUILDING
CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER e
LOCATION OF INSPECTION -
CO
s
NAME OF OWNER NTRACTOR_� Y
a c
„
DATE INSPECTION REQUESTED: TIME INSPECTION REQUESTED-- PERMIT NO: i
TYPE OF INSPECTION REQUESTED:CONFERENCE `
��:�„�,n�,r�����-m,����..�..__���.�_� __ _ ❑ � F1 STATUS CHECK t
BUILDING:
❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
PASSED FAILED
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC El 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
INSPECTOR: ` DATE OF INSPECTION MADE: — b TIME
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
j
�• CITY OF BLAIR
LOCATION OF INSPECTION.
BUILDING ' REPORT
❑ WASHINGTON COUNTY ❑
r
r
NAME OF OWNER • _; . ' a % E _ CONTRACTOR
1
DATE INSPECTION REQUESTED1 L TIME INSPECTION REQUESTED PERMIT
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
BUILDING: ❑ FOOTING ❑ DECKFOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL
COMMENTS:
h7 �
❑ STATUS CHECK
PASSED FAILED
❑ ❑
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 El WATER METER INSTALLED ARTIAL
PASSED
FAILED
ElPRESSURE
TESf�✓,', 'f>�� r °
E]COMMENTS:
.. 1 : 1 ,! �` - :o'' ._
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
.e c - +e-4,
INSPECTOR �DATE OF INSPECTION MADE: 0 TIME:
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON B
NOTES/REMARKS• 09 /3 A f/ 11
z 64,41 !f fA f 0 5 a i- Ho 4, w 'A ev, K wtefet 10ae5suo-e-
00 0
b 0 Z)
a- c _s j4kot 5-())c)oU vjf/`A
INSPECTOR- DATE OF INSPECTION MADE: —j4 -/ c) TIME- 4t?_"V3_
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
BUILDING INSPECTION REPORT
ITY OF BLAIR
F1 WASHINGTON COUNTY E:l OTHER
LOCATION OF INSPECTION-
NAME OF OWNERO
411- 1 fl
CONTRACTOR:
4 (JO
DATE INSPECTION REQUESTED- PERMIT
TIME INSPECTION REQUESTED -
NOL -1
TYPE OF INSPECTION REQUESTED: El CONFERENCE
F] STATUS CHECK
BUILDING:
FOOTING F] DECK FOOTING :x'❑FRAMING Ej DRYWALL Ej FINAL ARTIAL
PASSED
FAILED
)<
❑
COMMENTS:
UTILITIES: ❑
SEWER TAP El SEWER El SEPTIC F1 WATER TAP [:1 REMOTE El WATER SERVICE
PASSED
FAILED
F]
PARTIAL
1-1
El
COMMENTS:
ELECTRICAL: F]
ROUGH IN F -I FINAL El PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
[_1
PARTIAL
F]
❑
COMMENTS:
MECHANICAL Q`
ROUGH -IN F -I A/C [:1 FURNACE El RADIANT HEAT D FINA
PASSED
1LED
El
COMMENTS:
PLUMBING: F -I
GROUNDWORK El ROUGH -IN El FINAL El WATER METER INSTALLED El PARTIAL
PASSED
FAILED
El
PRESSURE TEST
F -I
F
COMMENTS:
F -I OCCUPANCY GRANTED F1 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS• 09 /3 A f/ 11
z 64,41 !f fA f 0 5 a i- Ho 4, w 'A ev, K wtefet 10ae5suo-e-
00 0
b 0 Z)
a- c _s j4kot 5-())c)oU vjf/`A
INSPECTOR- DATE OF INSPECTION MADE: —j4 -/ c) TIME- 4t?_"V3_
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
BUILDING INSPECTIONT
[Q=, CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER
f t1 £ & [p
LOCATION OF INSPECTION:
NAME OF OWNER' CONTRACTOR-
t
TIME INSPECTION REQUESTED- ` PERITNODATE INSPECTION REQUESTED
yl, �g
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 VPARTIAL
PASSED
FAILED
'kt-
❑
COMMENTS:
PLUMBING: ❑ GROUNDWORK ❑,YROUGH-IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑ PRESSURE TEST
❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
u C /tJo I• t r-' )y r N'4a,,,) bo a fie -ms
L@ 4 L''/l C eXt
L >acs A6 rJar/ZSAj
/ AA P_ -S4
t I—F Lec c� cc a G� ��t,� t✓c�Lc
U- r,uv.de -fxfc- e(Lecf.
INSPECTOR_� iii!_ DATE OF INSPECTION MADE: - ( O TIME.
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
yei
VSPE(-M)v MAI* _ -- nw.
p �Y
711
7/16/2010 1:04pm
�; 1i Lj
7/16/2010 1:04pm
COMMENTS:
F-1 OCCUPANCY GRANTED F1 CONDITIONAL OCCUPANCY GRANTED
-1) t
INSPECTOR. DATE OF INSPECTION MADE: 7-,/ 6 TIME -
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON B
BUILDING INSPECTION REPORT
CITY OF BLAIR
E:l WASHINGTON COUNTY ❑OTHE
LOCATION OF INSPECTION- S,' _4"
NAME OF OWNER-
U CONTRACTOR
DATE INSPECTION REQUESTED- '-2 TIME INSPECTION REQUESTED- PERMIT
NO -
TYPE OF INSPECTION REQUESTED: EICONFERENCE
El STATUS CHECK
BUILDING: F]
FOOTING Fj DECKFOOTfNG [:1 FRAMING E:l DRYWALL"El: FINAL PARTIAL
PASSED
FAILED
F�
COMMENTS:
UTILITIES: F -I
SEWER TAP El SEWER El SEPTIC F] WATER TAP F] REMOTE F WATER SERVICE
PASSED
FAILED
F
PARTIAL
El
El
COMMENTS:
ELECTRICAL: F
ROUGH IN [_1 FINAL F PERMANENT SERVICE F] TEMPORARY SERVICE F PRECONNECT
PASSED
FAILED
El
PARTIAL
El
El
COMMENTS:
MECIIANICAUF
ROUGH -IN El A/c F -I FURNACE D RADIANT HEAT "El, FINAL [:1 PARTIAL
PASSED
FAILED
,)K
El
COMMENTS:
PLUMBING: F -I
GROUNDWORK F ROUGH -IN )2,, FINAL El WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
El
COMMENTS:
F-1 OCCUPANCY GRANTED F1 CONDITIONAL OCCUPANCY GRANTED
-1) t
INSPECTOR. DATE OF INSPECTION MADE: 7-,/ 6 TIME -
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON B