BP8056R /~ ~3~1 I 1 o~i2~98
Permit #: 8056
The City of Blair Building Permit Detail
Issued: 02/20/1998
Completed: 09/24/1998
Type: Residential -New Construction
Valuation: $100,000.00
Owner: Charles Hall
Address: 1074 N. 28th Street
Blair, NE 68008
Phone: 402-426-3357
Permit Fee: $475.00
Issue Fee: $15.00
Deposit Amt.: $200.00
Receipt #: 6701
Section: Township: Range:
Subdivision: LARSEN-4TH Lot: 1 Block: 1
New home, Ranch, 3 6di•ms, 2 baths, 2 1/2 attached garage, no bedrooms in basement;-rear covered deck. Work
#468-5666. R.J. Builders is assisting in the project.
Inspections Date By
02/24/1998 KAR Footings Pass
03/16/1998 DEM Electrical Temporary Service Pass
04/13/1998 KAR Water Service Pass
04/13/1998 KAR Sewer Lines Pass
05/14/1998 DEM Plumbing Rough-ins Pass
05/14/1998 DEM Mechanical Rough-ins Pass
05/14/1998 DEM Electrical Rough-ins Pass
05/14/1998 DEM Framing Pass
06/11/1998 KAR Electrical Permanent Service Pass
09/22/1998 DEM Final Inspection of Project Fail
09/24!1998 DEM Final Inspection of Project Pass
Remarks
Contractors
SELF General Contractor Permit # Issued
Aksarben Heating & A/C, Inc. Heating Subcontractor 377 06/02/1998
Blair Plumbing Plumbing Subcontractor 321 04/06/1998
Dick's Electric Co. Electrical Subcontractor 353 05/1411998
BUILDING PERM11' APPLICATION ~.C~~
~' ~-p Jurisdiction of City of Blair, Nebraska , /~
Permit Fee: 218 South 16th Street ~7
Issuance Fee: ° ~~ ~ Blair, Nebraska 68008 8 0 5 6
Deposit Receipt #: C~' `` (402) 426-4191 • Fax (402) 426-4195 Permit
Application Date: ~' ~Q "'1~ Issue Date: ~ ~6
JOB ADDRESS C
LEGAL
1. DESCR. LOT ND. BLK.
1 TRACT
, ~~~,l,lf - SEE ATTACHED SHEET
OWNER MAI DDRESS ZIP PHONE
CO AG OR MA AD RESS ZIP PHONE
4. Class of Work:
- NEW O ADDITION O REMODEL
- i ~~
\ -1 - -- -
5. Describe Work: ~~) ._ ~VYI~ O Finished Basement Unfinished Basement
Z' z v'- ~ 2
6. Total Sq. Footage (Including Basement and Garage): ~ ~ Total Finished Area: ~ 2,~
7. Valuation of Work: $ ~j~j ~G~
Floodway
8. Floodplain: Fringe O Yes No
O Yes O No Dev. Permit
BFE
Elev. Cerl.
9. Current Zoning:
10. State Fire Marshall Required: O Yes O No
11. Special Use Permit Required: O Yes O No
12. Variance Required: O Yes O No
r
13. Minimum Setbacks: Front ~ Side ~ Rear ~'~
14. Sidewalk Required:,l~J Yes O No Waiver Approved
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septicsystems. By my signature below, I acknowledge that payment
of the building permit application fee does not constitute issuance of this building
permit. I furtheragree that construction covered by this permit application shall not be
commenced until I have received a copy of this application form signed bythe 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 thatthis permit is void if work is not commenced within
0 days or is not completed withi 2 year f date of issue.
'~_r~ ~ a ~ ~GI~~
OF OWNER/CONTRACTOR
Comment:
DATE
~~~~~~~
NEC COOS RECUiAEMENTs ~,~
irk ~GL ~~.~=~,~~,~~ egS ~,~
~~€~I~~7 /~1 ~,~~ ~~~~N~~~ ~ ~~~, ors:
O Site Plan Attached O Complete Plans Attached
Approximate Completion Date
Inspections Required and Fees
Utilities
Sewer _
kl
Water Service
Septic Remote '
Stop Box Card
Building
Footi ~ p
(before finish)
Fra~ Figat~
~ ~ ~
~
Electrical
L
Rough Fixt~res~
Final Permanent S~
Temp ervice
Mechanical
Rough.it~
Final
Plumbing / ~arT Vim/ ~
Ground W
Rough jLl~ ~ /
WHEN PROPERLY VALIDATED (I UR PERMIT
Rev. e196
, PRTG: BIaIr, NE ~
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street ~~~ 7
Blair, Nebraska 68008
(402) 426-4191
~ ~ ~Z -GS I I /fit I
Application Date: ~ ~~ ~"
Permit Fee: $ - ` ~~
JOB ADDRESS
l~ / ~•~ 1
LEGAL
1 • DESCR. LOT NO. BLK. TRACT
O SEE ATTACHED SHEET
2. OWNER ~ ~ ~ ~ ~ MAIL ADDRESS ZIP ,r.,PHQNE ~- ~~
3. C C MAIL RESS + ~1~, HONE (
f~' Q~ T `7 `" `~ ~ J ; ~ ~ LICENSE NO.
4. -Class of-Work: -NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITION ~"`-~O R LPE ACEMENTS -
6. Describe Work: ~ ~ ~-
Comments:
MECHANICAL PERMIT FEES
~ ` ~U
Forced Air Systems
Per Unit Commercial/Residential (New) ........ .............................. $25.00
~~ ' ~
Air-Conditioner Unit
Per Unit Commercial/Residential (New) ........ .............................. $10.00
Refrigeration Units/Coolers
Per Unit Commercial (New or Replacement) .............................. $10.00
NOTICE
I hereby certify that I have read and examined this Forced Air Systems/Air Conditioner
application and know the same to be true and correct. All Unit Replacement
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not.
Per Unit Commercial/Residential (Replacement) ........................ $10.00
The granting of a permit does not presume to give authority
to violate or cancel the provisions of any other state or local
law regulating construction or the performance of
construction. /~~ ~
1
Permit Issuance Fee ............. $15.00
` ~ TOTAL • L~
If NATUREOF.CONTRAC70RORAUTHORIZED.AGEMT~
;~,
~~~~ Current License on File ~I-Yes O No O NA
`~. ~DAT
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By: `~
POUNDS PRTG: Blair, NE Rev. 12!95
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street ~~~~ 0~
~~ Blair, Nebraska 68008
(402) 426-4191
Application Date: ~~ _~ ~-
Permit Fee: $ W~ r
JOB ADDRESS f ~ t~ I , r~
~{ ! V ~ -rl
1 , LEGAL
DESCR. LOT NO. BLK. TRACT O SEE ATTACHED SHEET
2.OWNE + MAILADDRESS
I ZIP ",~QNE ~~~~
S
r3. CONTRACTOR
\ , ,^^ MAIL ApDRE PHONE LICEN
E NO.
4• Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O REPLACEMENTS
5• Describe Work:. q _ ~ ~ ,~ ~ G~ ~ Pifer
t
C ~x (~-~
-s~
~ ~~ C ~s~
7 ~'(
f~ ~r'~
ommen
s: -
.
.
-
PLUMBING PERMIT FEES
Type of Fixture No.
~ ~ ` U~
Kitchen $8.00 x
................................
Bath ....................................... $8.00 x 2 ~ ~f? • U~
Rough-In Bath ....................... $4.00 x ~ ~ ~ ~
Utility ..................................... $5.00 x
Water Heater $3.00 x ~ ~ ~ ~~
Outside Water Faucet ........... $3.00 x ~' ~ ' ~
Water Service ........................ $10.00
NOTICE Sewer .................................... $10.00
hereby certify that I have read and examined this `
Groundwork ........................... $10.00 ,`
~~~ .
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of Septic Tank & Laterals ..........$10.00
work will be complied with whether specified herein or not.
The granting of a permit does not presume to give authority
Lawn Sprinkler System .......... $10.00
to violate or cancel the provisions of any other state or local
Sprinkler System ...................$30.00
law regulating construction or the performance of (Commercial)
construction.
Permit Issuance Fee ............. $15.00 ~~ ~ ~'~
SIGN URE OF CONTRACTOR OR AUTHORIZED AGENT (~
C
2
TOTAL D
DATE Current License on File ~'S'es O No O NA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
POUNDS PRTG: Blalr, NE Rev. 12195
ELECTRICAL PERMIT APPLICATION
cl~-~1-Q~ ~An (;~
lication Date: ~ `~6 '"1 C-~
pP
Permit ~ J ~ ~
Permit Fee: $ ~~~ ~ ~~
JOB ADDRESS i ~ ,, ` , ~~~
N ~~
LEGAL
1 • DESCR. LOT N0. BLK.
, TRACT 1~
1 ~~ j~
L ~.-.
O SEE ATTACHED SHEET
2. OWNER ~ ~~ I I ~ e\ M ADDRESS
~ ~ ~ (~~ ZI ., r ,~ PHONE ,` ~~
r3• CO AC10R ` .,
MAILADDRESS
~~ PHONE LICENSE NO.
4• Class of Work: NEW RESIDENTIAL O NEW COMMERCIAL O REMODELING/ADDITIONS O UPGRADE SERVICE
5. Describe Work: ~~i~ ~/~1 L ~ ~~ / ,~.-~ ._
6• Current License on File -Yes O No O NA
New Service Fee = (Amp Fee + $2.00 per branch circuit) ELECTRICAL PERMIT FEES
1-100 Amp Fee ............................ $ 13.00 Upgrade Existing Service ...... $10.00
101-200 Amp Fee ............................ $ 18.00 Temporary Service ................ $10.00 ~ ,
201-300 Amp Fee ............................ $ 30.00 Fire Alarm System $10.00
.................
301-400 Amp Fee ............................ $ 42.00
Signs ..............................
..
$15
00
401-500 Amp Fee $ 55.00
............................ .
....
.
501-600 Amp Fee $ 67.00
............................ Miscellaneous Apparatus ...... $11.00
601-700 Amp Fee ............................ $ 80.00 AC/DC Circuit ........................ $5.00
701-800 Amp Fee ............................ $ 92.00
801-900 Amp Fee $105.00 Commercial/Multi-Family and All Upgrades:
901-1000 Amp ................................. $117.00 # of Circuits x $2.00
IF OVER 1000 Amp Amp Fee
1st 1000 Amp Fee ....................... $117.00
Each additional 100 Amps ,.......... $ 13.00 Amp Fee + Circuit Total
N
R
id
i
l
Fi
ew
es
ent
a
: (
nished Area)
NOTICE
I hereby certify that I have read and examin
d thi Single/Tw~amily Dwellings
2 ,~ ~ o I
e
s - sq. ft. x .045
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of Modular/Manufactured Homes ....... $30.00
work will be complied with whether s
ecified herein or not
p
.
The granting of a permit does not presume to give authority
Receptacle/Switch Outlets
to violate or cancel the provisions of any other state or local Fixtures x $.75
law regulating construction or the performance of
construction. Smoke Detectors x $3.00
Residential/Commercial Appliance
# Fixed Outlets x $3.00
Motor(s) x $3.00
Power Apparatus (220 Volts)
SIGNATURE OF CONTRACTOR OR AUTHORIZE AGENT # ApparatUS X $3.00
~ ~~ Permit Issuance Fee .............$15.00 ~~
DATE
TOTAL
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
PUUNDS PRTG: Blair, NE Rev. 8197
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City of Blair
218 South 16th
Blair, Nebraska 68008
402-426-4191
Fax - 402-426-4195
4~^ Q
. , o~ O`~
~9 promise
BUILDING PERMIT DEPOSIT AGREEMENT
A $200.00 refundable deposit is being collected at the time of your building permit
application for all permits in excess of $10,000.00. However, the City reserves the right
to not refund this deposit if any of the following conditions occur during the construction
period: 1) water is connected without a meter by either the plumber, owner or general
contractor, 2) all required inspections have not been obtained (this includes drywall prior
to taping) as per attached checklists (Both Rough-In and Final), 3) occupancy or utilization
occurs prior to a final inspection, and 4) all permits have not been obtained. 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 may be forfeited or discounted upon the
discretion of the City of Blair, Building and Inspections Department.
Contractor/Owner
~ Ic ~
Date
EQUAL HOUSING
OPPONTUNRY
Contractor/Owner
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