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BP12250s]3~ 1~ ~~~~lzi ~~ City of Blair Building Permit Detail Permit #: 12250 Issued: 9/7/2005 Completed: 5/15/2006 Location: 1162 South Street Owner: Bob (Red) Jensen Address: 1162 South Street Blair, NE 68008 Type: Accessory Building Valuation: 12500 Permit Fee: 175 Issue Fee: 15 Deposit Amt.: 200 Receipt #: 15187 Phone: 402 426 4940 Section: Township: Range: Subdivision: Lot: Block: 25x25 Detached garage on concrete foundation 2 car garage. 2 walk in doors. 1 overhead door 8' walls toatal 12' 4/12 roof pitch. Contractors Nielsen Home Improvement General Contractor Permit # Issued SELF Electrical Subcontractor E2297 9/7/2005 Remarks 9/9/2005 DEM 2/17/2006 BMS Inspections Date By 9/6/2005 DEM 2/16/2006 DEM 5/15/2006 DEM 5/15/2006 DEM Sent copy of permit. Brandy Changed completion date to 5/15/2006 Footings Pass Final Inspection of Project Fail Final Inspection of Project Pass Electrical Final Pass BUILDING PERMIT APPLICATION Permit Fee: ~~~f~ urisdiction of City of Blair, Nebraska ~~ , 218 South 16th Street Issuance Fee: (~~~~ ~ ~~, ~ Blair, Nebraska 68008 Receipt #: ~ C?,f~02) 426-4191 • Fax (402) 426-4195 Permit- 12250 Deposit Receipt #: ~~ (~ ~ Issue Date: ~ ~~ Type: ~. ~ JOB ADDRESS + I l ~ ~" r t~(,, ~J~V `Y ~ j,, ~L LEGAL 1 . DESCR. ^ SEE ATTACHED SHEET OWNER 2. { LADpRESS L ~ ~+ Zip HOME PHONE WORK/CELL PHONE CONTRA TOR 3.N ~~ ~ MAIL ADDRESS _ _ ~ ~ ZIP Ma `/Q [,~, HOME PHONE ~,~" '-1 -WORK/CELLPHONE~ ~~ I 4. Class of Work: ^ NEW ^ ADDITION ^ REMODEL OTHER ^ FINISHED BASEMENT ^ UNFINISHED BASEMENT 5. Describe Work: ~ x' ~ ~ i { l}V t - o~ ~V ~ ~v ~. ~ ~ -. ~ is ~~-~~~.~ ~-~ 2 ~~ 1'~.~ 6. Valuation of Work: $ ~~~~~(~' Total Sq. Footage pROludingBasementanaGarage): Total Finished Area: Floodway Q Yes Q No 7. Floodplain: Fringe ^ Yes ~ No Dev. Permit BFE Elev. Cert. 8. Current Zoning: ~~~~ 9. State Fire Marshall Required: ^ Yes ~No 10. Special Use Permit Required: ^ Yes j~No 11. Variance Required: ^ Yes [Flo 12. Minimum Setbacks: Front ~ Side ~t Rear ~ 5t 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 by this permit application shall not be commenced until I have received a copy of this application form 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/ordinances of the City of Blair and the State of Nebraska.lunderstandthatthis ifworkisnotcommencedwithin 180 days t comple wit ' years ofd of issue. - -U IGNA RE OF OWNER/CO TRACTOR DATE Comment: MEET IBC, IRC, lPC, IMC AND NEC COOS REQUIREMENTS ^ Site Plan Attached ~C~ ~gmpl~~tached Approximate Completion Date lL Inspections Required and Fees ili i Sewer _ Septic _ Stop Box Card B it in Footin~ga~_ Roug Fi Temporary Service Mechanical Rough-in _ Final Plumbing - Ground Work Rough-in _ A1C , Final Y VALID~yED (IN THIS ~EA~IS YOUR PERMIT Water Service Remote Drywall (PRIOR TO TAPING) Fir Fixtures Permanent Service Rev. 8/96 POUNDS PRTG: Blair, NE ~ ~ ELECTRICAL PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 2 2 9 (402) 426-4191 Permit E ~~ Application Date: ~ ~~ Permit Fee: $ ~~ JOB ADDRESS //~~ ' ~~~~.~ 1,,~E~aL ~ SEE ATTACHED SHEET DESCR. 2 OWNER ~ ~ MAIL ADDRESS ~ ~ ~ ZIP HOME PHONE ''LL 7 WORKICELL PHONE T v 3. CONTRACT 9. MAILADDRESS PHONE HOME PHONE T WORK/CELL PHONE 4. Class of Wor : p NEW RESIDENTIAL O NEW COMMERCIAL EMODELING/ADDITIONS O UPGRADE SERVICE 5• Describe Work: ~~ ~ ~~ ~ ~ ~ ~~~ ~~ 6. Current License on File O Yes O o O NA Completion Date 3 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 Fire Alarm System ................. $10.00 301-400 Amp Fee ............................ $ 42.00 Signs ..................................... $15.00 401-500 Am Fee $ 55.00 p ............................ $ 501-600 Amp Fee ............................ 67.00 Miscellaneous Apparatus ...... $11.00 //~ (~Q 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 Singled-wo 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 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 constru n. Residential/Commercial Appliance # Fixed Outlets x $3.00 Motor(s) x $3.00 Power Apparatus (220 Volts) S NATURE OF CONTRA R OR AUTHORIZED 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: % __ ~ - ~'~/lX POUNDS PRTG: Blair, NE Rev. 11/99 BUILDING INSPECTION REPORT- CTI'Y OF BLAIR ^ WASHINGTON COUNJT//Y~~ ~ ^~rO~T,HECR LOCATION OF INSPECTION• (` l(/ ~ 1=~./ I V l J~ NAME OF OWNER• ~C~ °`•-~ - Cam' ` CONTRACTOR: ~' ~~ `~ ~~~ ~~ pI U~" ~~-t /~_ ~--- DATE INSPECTION REQUESTED: ~ ~ ~ L y~ TIME INSPECTION REQUESTED• ~ ~' ~ PERMIT NO• ~~~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE. ^ STATUS CHECK ~' BUILDING: I~4 J~ 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 PASSED FAILED ^ ^ COMMENTS: PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL PASSED FAILED ^ PRESSURE TEST ^ ^ COMMENTS: ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED T ~ f C~ FAXED OPPD~BURT REA TO CONNECT SERVICE: ON BY (:fTY OF B LOCATION OF INSPE ON: tJn~nFnwniFU• BUILDING INSPECTION REPORT ^ WASHINGTON COUNT/Yn ~f ~y ^ OTHaER/ C ~a~ -~9~~ DATE WSPECTION REQUESTED' ~~/~ ~ y ~ TIME INSPECTION REQUESTED• //' ~~~ '~ ' PERMIT NO• ~~~~[./ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE ^ STATUS CHECK BUILDING: ^ FOOTING ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PA FAIL COMMENTS: ~->a~lQ ~P ,~~ UTILITIES: ^ SEWER TAP • ^ SEWER ^ SEPTIC ^ WATER TAP ^ EMOTE ^ WATER SERVICE PASSED FAILED ^ PARTIAL ^ ^ COMMENTS: ELECTRICAL: ^ ROUGH IN ^ FINAL ^ PERMANENT SERVICE ^ TEMPORARY SERVICE ^ PRECONNECT PASSED FAIL ^ PARTIAL ^ rj~'( 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 ~ y,/~L! L/ DATE OF INSPECTION MADE: //.' FAXED OPPD~BURT REA TO CONNECT SERVICE: ~ ~~~ BUILDING INSPECTION REPORT r ^ CTI'Y OF BLAIR ^ WASHINGTON COUNTY ^ OTHER" LOCATION OF INSPECTION• /~(~/ ~©~~~1~~/-~~%~~:~~ 7` NAME OF OWNER• ~~~ S CONTRACTOR` ~°-- DATE INSPECTION REQUESTED• /~ TIME INSPECTION REQUESTED• ~ ~7 PERMTI' NO• /~ TYPE OF INSPECTION REQUESTED: ^ CONFERENCE BUILDING: ^ FOOTING ^ STATUS CHECK ^ DECK FOOTING ^ FRAMING ^ DRYWALL FINAL ^ PARTIAL PASS D FAILED COMMENTS: ^ UTILITIES: ^ SEWER TAP. ^ SEWER ^ SEPTIC ^ WATER TAP ^ REMOTE ^ WATER SER ^ VICE PARTIAL PASSED FAILED COMMENTS: ^ ^ ELECTRICAL: ^ ROUGH IN ~ FINAL ^ PERMANENT SERVICE ^ TEMPORAR ^ Y SERVICE PARTIAL ^ PRECONNECT PAS D FAILED COMMENTS: ~ ^ MECHANICAL ^ RO : UGH-IN ^ A/C ^ FURNACE ^ RADIANT HEAT ^ FINAL ^ PARTIAL PASSED FAILED COMMENTS: ^ ^ PLUMBING: ^ GROUNDWORK ^ ROUGH-IN ^ FINAL ^ WATER METER INSTALLED ^ PARTIAL ^ PRESSURE TEST PASSED FAILED COMMENTS: ^ ^ ^ OCCUPANCY GRANTED ^ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS: MADE: TIMF• ~c,~ FAXED OPPD~BURT REA TO CONNECT SERVICE: d~t~' CITY OF BLAIR Application for Building Permit Address ~~j)p~ _~_~ ~ Date ~ ~ °' (~ ~~ Legal Description: Lot Block Addition Please show all measurements of existing and contemplated structures, also show distances between structures, etc,, and property lines. Is this a corner lot?_~U ' t'ro er-t Line _. a c •r F- 0 w ~1/ J J~ `• S ~ ~~ I l ~0~ x~~ ~ ~~ 2 t~4 ~~ ~ti`~1 t -~ .. ' _ _Center Line_of _ _ _ Cndi~at~--North ' _- .i J~ ~n / ~ Street_ _ Applicant CITY OF BI~f~IR 9 '~r~ o~~se of HOMEOWNER VERIFICATION FOR ELECTRICAL WIRING PERMITS 1- ~ 7~ your ~ name online above: states the following: 1. I am the owner of the single family dwelling for which I am applying for an electrical permit. Address: 2. I am applying for an electrical permit for a single family dwelling and it is or will be my principal residence. 3. I will install and connect the electrical wiring for myself, without compensation or pay from or to, any other person. 4.. I have sufficient knowledge of the 2002 National Electrical Code requirements to make an electrically safe and mechanically secure installation which will meet the minimum standards referenced in 81-2104. 5. I am aware of all inspections required prior to a final. 6. I will call twenty-four (24) hours in advance for an inspection. I am also aware that it is not the inspector's job or duty to be my instructor in electrical wiring. 7. I am aware that Nebr. Rev. Stat. 81-2143 makes it a Class 1 misdemeanor to make a false statement on a request for inspection. 8. above information is true an correct. ~= 7~- ~. ~ Date ~~ _ ~_ 218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@huntel.net ~ :m CITY OF BI,f~IR 'fir o~/se of d BUILDING PERMIT DEPOSIT AGREEMENT A $~_00~. 0 refundable deposit is being collected at the time of your building permit application for all permits,$10~Q0 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. U~%~~ ~ Contractor/Owner Contractor/Owner City of Blair ~'^ 7~O Date 218 South 16th Sfreet • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cilyofblair@huntel.net ,~~° CITY OF' BI~t1Il~ ,Or~_ 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 ~' ~ 5 Date 218 South 1 bth Street • Blair, Nebraska 68008 • 402-426-4191 • fax 402-426-4195 • E-mail ciiyofblair@huntel.net ~m %.//ShOr~'~nin~ ,~~~ ~ .~ ~ 1 ~~ ~ S l~~it r C1~ L~ ~ W (o ~~ ~'~ ~ ~\l L~ ,~~.~~! A~~-c _c~1~~ ~~~Q~~ Jul ~ (~c~~ ~x u S~~ d~ ~~~~ -~~~iL~. Co~nC ~`2`Y~Q T~~ ~~~~~a ~_ ~, ~~ ~c~~~ ~, „ ~~~~~ ~- X ~~~ C ~' -- ~' ~~`\~~ ~.E ,. ~`, ~~ ;. :~ ~~~ ~, > ~~ T G r4 ~_ ~; ~r ~,` d 1 {\ 1 1~, Z 0 (v r~.y ~q 3~ !+~l~ '`->> ~~ ~~ ~ ~ 9 ~" 1\ ~~ f ~ A ~ , fY a, a: e, 39~' ~ . '. ~# ~ ;~" ~n .~,° ~~~ ~ ~~ ;~;: va~3 L ~~.1~ i~S+~'~~~~ t ,~~9~s .v~'i '" ~,,.r w r `1 ~ p' 'I ,,,,.. ~~f .. I < . ~ p I ~ ~y ~ I ~ ~ _ t R: Z t. , .ti h ~Y ~ .~ •~U~,. fib. > ~ ,~~ {~ _ ~ ~. ~, _ a ~ b ~" ~ r ~. w ... 7F-:w .ps .~. ~ r n' . ~~~ aa~ ..~w ,. ~ ~'~,rr. ~i t' r~ ~ y / ,~~ , P_''y- . B / ~"r.• ~ k.~ .a' ~a~'r ! ~. ~ y.'~ ~ ~ ti °~ i~ ~r ~ . 1 ~ ~ Y'~ ~ ~ ~1 ~ ~ • 1 a - ~ _ _ .. 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