BP11330
City of Blair Building Permit Detail
Permit #: 11330 Issued: 8/13/2004
Completed: 12/21 /2004
Location: 1008 Stonecreek Drive
Owner: Jim & Laura Nelson
Address: 1008 Stonecreek Drive
Type: Garage -Additions
Valuation: 18500
Blair, NE 68008
Phone: 426-1976
Section: Township: Range:
Subdivision: Lot:
Adding to make a 3-car garage -17' x 22'; adding electrical
Contractors
Warrick Construction Co.
General Contractor
Remarks
Inspections Date
8/17/2004
11 /8/2004
11 /8/2004
11 /15/2004
12/21 /2004
By
DEM Footings
DEM Electrical Rough-ins
DEM Framing
DEM Drywall
DEM Final Inspection of Project
Permit Fee: 92.5
Issue Fee: 15
Deposit Amt.: 200
Receipt #: 12353
Block:
Permit # Issued
Pass
Pass
Pass
Pass
Pass
BUILDING PERMIT APPLICATION
~,~~- I ~;~`~, ~} Jurisdiction of City of Blair, Nebraska
Permit Fee: 218 South 16th Street
Issuance Fee: e1~ r~ Blair, Nebraska 68008
Receipt #: (402) 426-4191 • Fax (402) 426-4195 ~ Permit 1 13 3 0
Deposit Receipt #: ,/~
Issue Date: ~ ~`~ ' Type: ~ .!~J`~' l~' - I
JOB ADDRESS I /'~ ~~"J ~C~' I/~,,, ^ ,~ ~n ~ \ ~, /~
Il v XU ~ ~ }+ ~/ K: v `~
LEGAL
1 . DESCR. ^ SEE ATTACHED SHEET
2 OWNER t r' e , n ~~, ,/)MAIL ADDRESS , ~~ ZIP WORK/CEOLL PHONE E~.G/ -
3. CONi T ~~ ~~ ' AIL ADD S
l ~ P HOME PHONE
~~11 WORK/CELLPHONE ~--a
FINISHED BASEMENT ^ UNFINISHED BASEMENT
4. Class of Work: Q NEW ~ ADDITION O REMO L Q OTHER
^
/
~
5. Describe Work: +~/~ ~~,~,{,~ `" C~'l ~'1 ~L
1 - (~ ~~ ~ r ,...
I~1 ~ ~. ~L.~
6. Valuation of Work: $ ~~ ~(~~, Total Sq. Footage pnaudlRgBasememaRdGarage): Total Finished Area:
Floodway ^ Yes ^ No Dev. Permit
7. Floodplaln: Fringe ^ Yes ^ No BFE
Elev. Cert.
8. Current Zoning:
9. State Fire Marshall Required: ^ Yes
10. Special Use Permit Required: Q Yes
~No
,~No.
11. Variance Required: Q Yes 'No
12. Minimum Setbacks: Front ~ Side _~ Rear
13. Sidewalk Required: ^ Yes ~' No Waiver Approved .
NOTICE
Separate permits are required for electrical, plumbing, heating, ventilating and air
conditioning, and septic systems. By my signature below, I acknowledgethat payment
of the building permit application fee does not constitute issuance of this building
permit. I further agree that construction covered bythis permit application shall not be
commenced until I have received a copy ofthis 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
StateofN raska.lunderstandth tthispermitisvoidifworkisnotcommencedwithin
180 days o is not completed within 2 years of date of issue.
SIGNATURE OF
-~ .-
DATE
Comment:
MEET IBC, IRC, IPC, IMC AND NEC CODE REQUIREMENTS
SLEEPING ROOMS BELOW THE FOURTH
STORY AND IN BASEMENTS ARE
REQUIRED TO HAVE AN EGRESS WINDOW.
^ Site Plan Attached I ~ Q Cpmplete Plans Attached
Approximate Completion Date ~ / ~ I i~~ ~
Inspections Required and Fees
Ili i
Sewer
Septic
B it in
Foot' s
Fra ng
Water Service_
Remote
Stop Box Card
Drywall
(PRIOR TO TAPING)
F~
Rough( Fixtures
F'l'ea' Permanent Service
Temporary Service
Mechanical
1 Rough-in A1C
Final
Plumbing
Ground Work
Rough-in Final
WHEN PROPERLY VALJDATE-D (IN THIS SP HI YOUR PERMIT
Rev. 8/96
POUNDS PRTG.-Blair, NE
~/~
Application Date:
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
(402) 426-4191
IU~~~ ~~
Permit E 2 0 3 8
5,,1. ~~
Permit Fee: $
JOB ADDRESS ~° n ,,
/ ~~ ~ n'S V1'WC/l%zC~ lY 1~
1 LEGAL p SEE ATTACHED SHEET
DESCR.
NER n '~~ MAILADDRESS ZIP HOME PHONE I, ~y ~7
2
~
/~'
'
V '
~ " '
.
~j ~,, WORK/CELL PHONE
I
I
c
,3 C NTRA~TDR MAIL ADDRESS PHONE HOME PHONE
~ ~ WDRK/CELL PHONE
4. Class of Work: O NEW RESIDENTIAL D NEW COMMERCIAL EMODELINGIADDITIONS O UPGRADE SERVICE
~
5• Describe Work: ~
~!
:
, ,,
~
~
6. Current License on File Yes p No DNA Completion Date
ELECTRICAL PERMIT FEES
New Service Fee = (Amp Fee + $2.00 per branch circuit)
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
y .................
Fire Alarm S stem $10.00
301-400 Amp Fee ............................ $ 42.00 Si ns $15.00
g ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
401 -500 Am Fee $ 55.00
p ............................
p ..........................
501-600 Am 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
New Residential: (Finished Area)
NOTICE Single/Two Family Dwellings
I hereby certify that I have read and examined this 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 specified herein or not.
The granting of a permit does not presume to give authority
Receptacle/Switch Outlets° ~ u ~ S~ - ~~ u
to violate or cancel the provisions of any other state or local Fixtures -~- x $.75
law regulating construction or the performance of Smoke Detectors x $3.00
construction.. Residential/Commercial Appliance
# Fixed Outlets x $3.00
~ Motor(s) x $3.00
Power Apparatus (220 Volts)
SIGNATURE OF CONTRACTOR OR AUT RIZED AGENT # Apparatus x $3.00
-/ ~~ G ~ Permit Issuance Fee ............. $15.00 ~~ ~'~
DATE TOTAL
~~~~ ~''
~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
Comment: Approved By:~ G~i1/~~~~~~
POUNDS PRTG.-Blair, NE Rev. 11/99
-- ----- T ~--_-_._- ------
.. • BUILDING INSPECTION REPORT
^ CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
LOCATION OF INSPECTION: ~ ~ U d
NAME OF OWNER• ~ " R CONTRACTOR: ~" Gf%~1/1.~.ti"'`
DATE INSPECTION REQUESTED: ~ ~ ~ ~ TIME INSPECTION REQUESTED• ~ " ~ ~ PERMTI' NO• ~ '
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: FOOTING l^ DECK FOOTING ^ FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASS 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 ^ ^
CQMMENTS: "
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
n
NOTES/REMARKS•
3
DATE OF INSPECTION
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON
~4 , ,~~_ BUILDING INSPECTION REPORT =
~J CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER
/ LOCATION OF INSPE N• ~ vO~ d!) - `-' ~ "~ " `~c-~ ~3 "~~~~
NAME OF OWNER• CONTRACTOR• '' ^ C~CJ ~ `~-~' ' ~"` ~~
DATE INSPECTION REQ ESTED• I ~ "' ~ TIME INSPECTION REQUESTED• ~ ~ W PERMTI' NO• `~
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING FRAMING ^ DRYWALL ^ FINAL ^ PARTIAL PASSED FAILED
COMMENTS: -
UTILTTIES: ' ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTLAL ^ ^ ~'~`
COMMENTS:
ELECTRICAL: ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSE FAILED
PARTLAL ~ ^
COMMENTS:
MECHANICAL' ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED
^ ^
COMMENTS:
PLUMBING: ^ GROUNDWORK ~ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSEp FAILED
^ PRESSURE TEST ~ ^
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
<.
{
,~~
~,~; (S
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
B~JILDIN~ INSPECTION REPORT
^ CTI'Y OPBLAIR ^ -•~'dASHINGTON COUNTY ^ OTHER
l~~~ ~-,
LOCATION OF INSPBCTION•
NAME OF OWNER• CONTRACTOR•
DATE INSPECTION REQUESTED• `~~ ~ ~~ TIME INSPECTION REQUESTED• ~ ~ 3 ~ PERMTI' NO• ~ ' J
TYPE OF INSPECTION REQUESTED:
^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING DRYWALL ^ FINAL ^ PARTIAL P S FAILED
COMMENTS:
Q%~tti--U~.t.~
^
UTILTI'IES: ^ 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:
_ S-~ ~ ,
INSPECTO ~ ~ DATE OF INSPECTION MADE: ~~ ~ / TID~~ ~
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY
BUILDING INSPECTION REPORT
CITY OF BLAIR ^ WASHINGTON COUNTY ~•,^ OTHER
/S LOCATION OF INSPECTION• ~ ~ ~ a
NAME OF OWNER• ~ I ~ ~ ~ ~ ~ ~ ~~
+I CONTRACTOR' ` i
DATE INSPECTION REQUESTED• a `6 ~ TIME INSPECTION REQUESTED• ~ `~ ~ ~ PERMIT NO•
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK
BUILDING: ^ FOOTING ^ DECK FOOTING ~ FRAMIIVG ^ DRYWALL ^ FINAL ^ PARTIAL PASS F ~ED
{
COMMENTS: ~~-CiQ
UTILITIES: ^ SEWER TAP ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SERVICE PASSED FAILED
^ PARTIAL ~ ^
COMMENTS:
ELECTRICAL: ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASS D .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• '~
i
FAXED OPPD~BURT REA TO CONNECT SERVICE: ON _ BY
.BUILDING•INSPECTION REP01~T
~~~
~TI'Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHER ~~~ ..
l~ o~ ~~~ Cpl'-ems [C~
LOCATION OF INSPECTION•
NAME OF OWNER• ~1 Y Y 1 ~ ~"' ~~~ ~~ " " E_I ~ ~ CONTRACTOR. " " ~ ~~
DATE INSPECTION REQUESTED• ~ I ~ ~ ~` ~ TIME INSPECTION REQUESTED• ~ o ' '2 `~ PERMIT NO• ~ ~•~
TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK.
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING DRYWALL ^ FINAL ^ PARTIAL PASS FAILED
^
C
.
C~ ~ C~
COMMENTS:
_._
.
UTILTPIES: ^ 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•
FAXED OPPD~BURT RE:A
v
TO CONNECT SERVICE: ON
BY
~~ ,
T ~
~, ~. E. ~ ~ BUILDING. INSPECTION REPORT
' CITY OF BLAIR ^ WASHINGTON COUNTY ^ OTHER_
LOCATION OF INSPECTION: ~v ~l~ ~~~~/ `~~~~ ~ `_,~~` /,~L
NAME OF OWNER~~.` ~j~~ /~"~~1 `) ~~?'li CONTRACTOR• //V~C~~ ~~/Y/~T
DATE INSPECTION REQUESTED• / ~` ~~/ ~ ~ TIME INSPECTION REQUESTED• ~ ! PERMIT N0: ~/~~J D
TYPE OF INSPECTION REQUESTED:
^ CONFERENCE ^STATUSCHECK:
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL ~ FINAL ^ PARTIAL PASS FAILED
COMMENTS
UTILTPIES:
~~ ^
^ 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
COMMENTS:
PASSED FAILED
^ ^
PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED
^ PRESSURE TEST ^ ^ '
COMMENTS:
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED
FAXED OPPD~BURT REA
TO CONNECT SERVICE: ON BY
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CITY OF' BI,~IR
'dr
o~/se of a
BUILDING PERMIT DEPOSIT AGREEMENT
A $200.00 refundable deposit is being collected at the time of your building permit
application for all permits $10,0000 and above. However, 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 either the plumber, owner or general
contractor, 2) all required inspections have not been obtained, 3) occupancy occurs
prior to a final inspection, 4) all permits have not been obtained, and 5) the project is
completed without a final inspection being done. 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
City of Blair
Date
218 South 1 bth Street • Blalr, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mall cliyofblalr@huntel.net
CITY OF BI,f~Ii~
.~~
o~/se of
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 2003 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.
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
Contractor
Date
218 South 1 bth Street • Blair, Nebraska 68008 ~ 402-426-4191 • Fax 402-426-4195 • E-mail ciiyofblair@huntel.net `,