Signature pagesre von -
a
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 r fundable deposit is being collected for any new commercial, new
residenti, , and any additions, remodels and accessory building valued $10,000 or
er 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:
heft of water service by the plumber, owner or general contractor.
fAA
ll permits have not been obtained.
ll required inspections have not been obtained.
ccupancy occurs prior to a final inspection.
he project is completed without a final inspection being done.
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.
Contr for/Owne
Contractor/Owner
ate City of Blair
CITY OF BLAIR
Z0S10H s
BLAIR NE 618208
_____________________
Description______________
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Permit # RN -2-1120-00052
J NIELSEN CONSTRUCTION'
��2609O CO RQ 33 BLDG PRMT
PEWIT PAYMENT
4,445.08
CHECK #
CHP -?..',4
Received ,4�.45445.00
J0
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FD
___________________FD 1O0.-6/20 15:21Rcptff 36 53
236 PART 4 0 Energy Conservation
N 1102.4* 1 CHANGE TYPE: Clarification
Sealing uii i CHANGE SUMMARY: Attic access openings and rim joist junctions
have been added to the list of specific locations requiring sealing to
Thermal Envelope prevent air infiltration.
2009 CODE: N1102.4.1 Building Thermal Envelope. The build-
ing thermal envelope shall be durably sealed to limit infiltration. The
sealing methods between dissimilar materials shall allow for differen-
tial expansion and contraction. The following shall be caulked, Bas-
keted, weatherstripped or otherwise sealed with an air barrier mate-
rial, suitable film or solid material.
1. All joints, seams and penetrations.
2. Site -built windows, doors, and skylights.
3. Openings between window and door assemblies and their re-
spective jambs and framing.
4. Utility penetrations.
Certify that the building is 5. Dropped ceilings or chases adjacent to the thermal envelope.
sealed as per code (2009 IRC) s. Knee walls.
7. Walls and ceilings separating the garage from conditioned spaces.
8. Behind tubs and showers on exterior walls.
9. Common walls between dwelling units.
10. Attic access openings.
11. Rim joist junction.
Contractor Name: -1e 12. Other sources of infiltration.
J Nielsen Construction
Chimneys
Recessed
Attic hatch lights
Rim
joist
Site Address: Lot 1 Co Rd 33
�r
Hidden Fawn Acres
Windows Ceiling Rim joist
corners junctions'
require
Electrical ® Doors sealing
outlets
���
Basement
window
Duct Sill -v b.
t
Date: �;eseal
Zignat_re dates � ti
Typical sources of air leakage