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Blair Building Permit Detail
Permit #: 12605 Issued: 10/18/2006
Completed: 11 /13/2007
Location: 2353 Park St.
Owner: James Cordle
Address: 2353 Park St.
Blair, NE 68008
Phone: 306 2408
Section: Township: Range:
Subdivision: Lot:
Storage Building. 192 Sq. ft. No electri c and no footings.
Type: Accessory Building
Valuation: 11520
Contractors
SELF General Contractor
Remarks
10/23/2006 BMP Sent copy of permit.
Inspections Date By
11/13/2006 DEM Final Inspection of Project
Permit Fee: 57.6
Issue Fee: 15
Deposit Amt.: 200
Receipt #: 17652
Block:
Permit # Issued
Pass
Blair Building Permit Detail
Permit #: 12605 Issued: 10/18/2006
Completed:
Location: 2353 Park St.
Owner: James Cordle
Address: 2353 Park St.
Type: Accessory Building
Valuation: 11520
Blair, NE 68008
Phone: 306 2408
Section: Township: Range:
Subdivision: Lot:
Storage Building. 192 Sq. ft. No electric and no footings.
Contractors
SELF
General Contractor
Remarks
Inspections Date By
MEET IBC, IRC, IPC, IMC AND NEC CODE REQUIREMENTS
`~7 :.
~~ ~ i 1
Permit Fee: 57.6
Issue Fee: 15
Deposit Amt.: 200
Receipt #: 17652
Block:
Permit # Issued
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BUILDING INSPECTION REPORT --- - -- -
CTI'Y OF BLAIR ^ WASHINGTON COUNTY
^ OTHE
LOCATION OFINSPECTION• n _/ 353 ,~J~./C
NAME OF OWNERS `~G ~ S l ~~(7~J vv ~'
CONTRALTO SCJ
DATE INSPECTION REQUESTED• / / ~3/ UFO
TIME INSPECTION REQUESTED•
TYPE OF INSPECTION REQUESTED: PERMIT
BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ CONFERENCE
^ DRYWALL~pINAL ^ PARTIAL
COMMENTS:
-.~~~
UTILTPIES:
^ SEWER TAP ^ SEWER ^ SEPTIC / V ra
^ PARTIAL ^ WATER TAP ^ REMOTE ^ WATFU c
COMMENTS:
~/ L
avaJC.a.al~al,taL: L__I xuuliri 1N LI FINAL a PERMANENT SERVICE
^ PARTIAL ^ TEMPORARY SERVICE ^ PRECONNECT
COMMENTS:
MECHANICAL: ^ ROUGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINS
^ PARTIAL,
/Z ~aS
^ STATUS CHECK
PASS /FAILED
~- _l
PASSED FAILED
^ ^
PASSED FAILED
^ ^
COMMENTS: PASSED FAILED
PLUMBING: ^ GROUNDWORK ^ ^
^ ROUGH-TN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL.
COMMENTS: ^ PRESSURE TEST PASSED FAILED
^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED ~ ^
DATE OF INSPECTION MADE: G
FAXED OPPD~BURT REA TO CONNECT SERVICE:
T '3~
a`
gPromise°`QJ CITY OF BLAIR -APPLICATION FOR BUILDING PERMIT
Permit # f 2 ~pQJr
Date: ~ OI ~ ~ ~ O ~ Approximate Completion Date: ~ ' ~ ~ --~ ~`-d ~'
Site Plan Attached: ~ REScheck Attached: Complete Plans Attached
Application for: Residential Commercial/Industrial
New Construction Manufactured Home Modular
Move-on: Home Accessory Building ~_ Other
Remodel Addition
Accessory Building: Garage Pole Barn Other ~Y~ ~ $(~~~
Floor Type: Dirt Concrete Electricity: Yes o _~
Other
Utilities: Public Water: Yes No Private Well
If yes, responsible entity: Blair OPPD Line Kennard
Agreement needed: Date Agreement Received:
Public Sewer: Yes No Septic Drawing Provided:
If yes, responsible entity: Blair Kennard
Miscellaneous Permits: Electrical Plumbing Heating,
County Road Permit Required: Yes No Submitted: Yes No
Additional Description of project if necessary: ~O -tc~cs-rtrlb.~
Project Information:
Job Address: X353 `~ar~L ~~-V ~-~T
Legal Description (if applicable)
Owner:~Ol M2S ~U~L~- ~~ Address: Z3~3 {dirk S~I , Phone#: 3v~_ Z~o~
Contractor: _ 5~~~ I ~PJ~~ Phone #:
Address:
Cell #:
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/or finances of the City of Blair and the State of Nebraska. I understand that this permit is void if work is not commenced within
180 day or is not gompleted within two (2) years of date of Issue.
Si nature of caner/Contractor Date
ZONING REVIEW:
Zonin~/Flood Plain/Utilities:
Current Zoning: _~~_ Conditional Use Permit Required: Yes No
Date CUP Approved:
State Fire Marshal Required: Yes No Variance Required: Yes No ,~
Minimum Setbacks: Front Second Front Side Side ~ _ Rear~,~
Lot Sauare Footage:
Length x Width: Lot Coverage
Driveways/S i d ewa I ks:
Sidewalk required: Yes No ,~~
Flood Plain: Yes No _~
If yes, specify special requirements
Sidewalk Waiver: Yes No
Date Waiver Approved:
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
Sauare Footage:
Main Level: ~,
Basement: (Unfinished)
Second Level: Third Level
(Finished)
Garage: 2 bay 3 bay 4 bay 5+ bay
Detached Garage: Pole Barn:
Addition: )t~ Remodel:
Porch: Front Rear Side
Deck that affect setbacks: Rear Front
Occupancv_Classification:
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
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 arotected by automatic fire sprinkler svstem~"
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: (percentage) (Dale will review new residential construction) (AI
will review all second access requests and industrial and commercial driveway requests)
Required Off Street Parking:
Permit Fee Calculation:
RESIDENTIAL -NEW CONSTRUCTION:
Buildings Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
All other permits valued under $10,000 No Deposit Fee
Permit fee is:
Finished sq/ft area X $88 $
(not including finished basement area)
Finished basement sq/ft area X $53 $
Unfinished basement sq/ft area X.$26 $
Garage sq/ft area X $20 $
Total Valuation: $
$ 0 TO $ 1,999 $ 15.00
$ 2,000 TO $ 4,999 $ 25.00
$ 5,000 TO $ 9,999 $ 50.00
$ 10,000 TO $ 49,999 $ 50.00 + $ 5.00 per 1000
$ 50,000 TO $ 99,999 $ 250.00 + $ 4.50 per 1000
$ 100,000 TO $ 199,999 $ 475.00 + $ 4.00 per 1000
$ 200,000 TO $ 399,999 $ 875.00 + $ 2.50 per 1000
$ 400,000 TO $ 999,000 $1,375.00 + $1.25 per 1000
$1,000,000 AND OVER $ 2,125.00 + $1.00 per 1000
Issuance Fee: $ 15.00
Total Permit Fee =Deposit/Permit Fee/Issuance Fee $
RESIDENTIAL -ADDITIONS /REMODELS and
COMMERCIAL -NEW CONSTRUCTION /ADDITIONS / REMODELS•
Business/Industrial/Educational/Assembly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Building Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $ ~~ ~
All other permits valued under $10,000 No Deposit Fee
Permit fee is:
Finished sq/ft area ~ q ~ X $60 $ I ~ , 52~ ~oc~
$ 0 TO $ 1,999
$ 2,000 TO $ 4,999
$ 5,000 TO $ 9,999
$ 10,000 TO $ 49,999
$ 50,000 TO $ 99,999
$ 100,000 TO $ 199,999
$ 200,000 TO $ 399,999
$ 400,000 TO $ 999,000
$1,000,000 AND OVER
Permit Fee calculated from chart above
Issuance Fee•
Total Permit Fee =Deposit/Permit Fee/Issuance Fee
Additional Comments:
$ ~~ ~ l~~
$ 15.00
$ ~~. ~~
Approved
$ 15.00
$ 25.00
$ 50.00
$ 50.00 + $ 5.00 per 1000
$ 250.00 + $ 4.50 per 1000
$ 475.00 + $ 4.00 per 1000
$ 875.00 + $ 2.50 per 1000
$ 1,375.00 + $1.25 per 1000
$ 2,125.00 + $1.00 per 1000
Date: D ~
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: 1 n' 1 ! ~- ~ ~
Permit Fee: _ ~ ~1 a , 6 0
Deposit Amount ~
Receipt # 17 ~ ~~ ~ ~` ~/f
Deposit Paid by for return to: ~~~ 1. 4~I G~~
Building Inspection Pouch given: Yes No
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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
Contractor/Owner
City of Blair
/D /9 ~~
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel,net
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