Signature PagesBUILDING PERMIT DEPOSIT AGREEMENT
t
�
4
� r
A 500.0 refundable deposit is being collected for any new commercial, new
residen ial, 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:
1ITheft of water service by the plumber, owner, or general contractor.
2 All permits have not been obtained.
All required inspections have not been obtained.
Occupancy occurs prior to a final inspection.
The project is completed without a final inspection being done.
W-9 is not filled out for return of deposit
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.
Contra
Z
Date
Contractor/Owner
City of Blair
CIT( T&AIR
MS IUHy
*Am + 68008 ~
------------------------------------------
Description
. ---------------------------------------
----------------------------------------
Amot
Permit 4
Smit# RN -22,021-00117
JQ INVESTMENTS
. .28100mg2 BLVII Gm#
. RmR PAYMENT
1,90&3
ACCONT BAL.
.00
RqReceive]
1,906u3
. . Change
,m
q 3/11/22 3:3 a 75
Y M
236 PART 4 N Energy Conservation
CHANGE TYNE: Clarification
Sealing of the Building CHANGE SA Y: 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: N11®2.4.1 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. _
Certify that the building is
sealed as per code (2009 IRC)
Contractor Name:
J&J Painting and Remodeling
Site Address: 2800 Krejci Blvd
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.
5. Dropped ceilings or chases adjacent to the thermal envelope.
6. 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.
4012. Other sources of infiltration.
Windows
Electrical
outlets
Basement
window
Date:
Signature:
Chimneys
Recessed
Attic hatch —f lights
Ceiling Rim joist
corners junctions
require
Doors sealing
Duct
Typical sources of air leakage
seal
Rim
joist
1) Building Plans
2) Site Plan
3) ResCheck
Address � Fou gjv�
Permit # fZfQ- 2:�j OJ/L7
New Construction Checkoff List
Date Received
10— dl -jjc�(
4) Water/Sewer Connection Fees
(Additional fees apply) ,
5) Given to Zoning
6) Zoning Approved
7) Site Plan Approved
8) Flood Plan Checked
9) Given to Building Inspector 10 —�"W/
Initials
772
Date Approve