BP12971
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Blair Building Permit Detail,,~.~
Permit #: 12971 Issued: 5/2/2008 Type: Accessory Building
Completed: 11/26/2008 Valuation: 29120
Location: 141 N 21st St
Owner: Jeff Willis Permit Fee: 165
Address: 141 N 21st St Issue Fee: 20
Deposit Amt.: 500
Blair, NE 68008 Receipt #:
Phone: 402 426 2872
Section: Township: Range:
Subdivision: Lot: 1 & 2 Block:
Construct accessory building 28x26 15' height and fence - see agreement also installing roof over front steps
attached to house not the ground. Removing fence and relocating.
Contractors
SELF
Judt Electric
Remarks
10/23/2008 OEM
Inspections Date By
7/16/2008 OEM
7/16/2008 OEM
10/23/2008 OEM
11/26/2008 OEM
General Contractor
Electrical Subcontractor
Permit #
E2914
Issued
7/11/2008
Fence post over 4'
Electrical Rough-ins
Framing
Final Inspection of Project
Final Inspection of Project
Pass
Pass
Fail
Pass
o
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # J ,,",, )7 (
,0'
Date:
'3'/2-
03
Approximate Completion Date: ~ I /) .~ l ~'
I
Site Plan Attached: REScheck Attached: Complete Plans Attached
Aoolication for: Residential X Commercial/Industrial
New Construction Manufactured Home Modular
- ---:r---
Move-on: Home _ Accessory Building \( Other
-------~~:~:::y BUilCling:-Garag~~~n Pole Barn_ Otner
Floor Type: Dirt Concrete Electricity: Yes _ No
Other
Utilities: Public Water: Yes_ No Private Well
If yes, responsible entity: Blair OPPD Line Kennard
Agreement-need~d: _ Date Agreement Received:_
Public Sewer: Yes_ No Septic Drawing Provided: _
If yes, responsible entity: Blair _ Kennard
County Road Permit Required: Yes_ No _ Submitted: Yes _ No _
Additional Description of project if necessary:
<' - -/ .
-fed ~ 01J f'\+ S
No+- ~ gy' ~~Vl~ ~(\(SL
Proiect Information:
. sf-. L
Job Address: ----14/ N. 2.1 S+V~
Legal Description (if applicable) 'fISc... N V;,
~
~10 c. Ol i-l^~
Bqoo *7 f.p '11/
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Owner:
--(f
J.e'
\N \' 11,\..3
So...~e
.~'J-rre....
Address:
S~~
Phone#: 1.f2.fJt .-2.'67Z
Contractor:
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/ordinances of the City of Blair and the State of Nebraska. I understand that this permit is void if work is not commenced within
180 days or is not completed within two (2) years of date of issue.
5!t-IO~
Signature of Owner/Contractor
Date
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ZONING REVIEW:
Zonin Flood Plain
Current Zoning: Conditional Use Permit Required: Yes _ No X-
Date cU~pproved:
State Fire Marshal Required: Yes_ No , varianC~R u' ed: Yes_. . NO_,
Minimum Setbacks: Front _ Second Front " Side Side _ RearL
,,,\ I/if( Y<c- ~ n. \ (, O~.v(
Lot Sauare Foota~e: JYY:YJvV/ ~ '\ X ~
Length x Width: Lot Coverage %
Driveways/Sidewalks: .. _____________~___
Sidewalk required: Yes No Sidewalk Waiver: Yes No
. Date Waiver Approved:
Flood Plain: Yes No Y
If yes, specify special r~ents:
BUILDING INSPECTOR REVIEW:
Number of Stories
One Two
Th ree
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 Foota~e:
Main Level:
Basement: (Unfinished)
Garage:
Detached Garage:
Addition:
Porch: Front
Deck that affect setbacks:
Second Level: Third Level
(Finished)
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front Side
Rear
Rear
Occupancy Classification:
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 _
r ~,
ELECTRICAL PER~tIi~M>JjleAllrVN
Jurisdiction of City of Blair, Nebraska I "'747/
218 South 16th Street ("/ I
Blair, Nebraska 68008
Fax (402) 426-4195 E 2914
(402) 426-4191
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VI.L .-f,7/..~1n I.MailAddress
2. cU LV er A.i e
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL 0 REMODELING/ADDITIONS 0 UPGRADE SERVICE
~~SCribeWork: 't)ClIJ.dip c3 & tU~ IdtPU (5 J;~ 10
5.Current License on File ~es 0 No 0 N/A Completion Date
ELECTRICAL PERMIT FEES
Application Date: 7 - I ( .-08
Job Address
Service Fee = (Amp Fee + 2.00 per branch circuit)
1-100 Amp Fee.... ................ ...$13.00
101-200 Amp Fee.......................$18.00
201-300 Amp Fee.................... ...$30.00
301-400 Amp Fee...... ......... ... .....$42.00
401-500 Amp Fee..................... ..$55.00
501-600 Amp Fee...... ............... ..$67.00
601-700 Amp Fee... ... ............ .....$80.00
701-800 Amp Fee... ... ............ .....$92.00
801-900 Amp Fee.................. ...$105.00
901-1000 Amp..................... ...$117.00
IF OVER 1000 Amp
1 st 1000 Amp Fee.............. ....$117.00
Each additional 100 Amps..... ....$13.00
Notice
I hereby certifY that I have read and examined this
application and know the same to be true and correct. All
provisions oflaws and ordinances governing this type of
work will be complied with whether specified herein or
not. 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.
Signature of Contractor or Authorized Agent
Date
Permit Fee: $307. 75
, ;J / 5 f- ( f.
Zip
Zip
Upgrade Existing Service........... ..$10.00
Temporary Service.................... $10.00
Fire Alarm System................. ....$10.00
Signs. .. . . . .. . . .. .. . . .. . .. . .. . . . . .. .. .... ..$15 .00
Miscellaneous Apparatus......... .....$11.00
AC/DC Circuit......... .............. ....$5.00
Commercial/Multi Family and All Upgrades:
# of Circuits x $2.00
Amp Fee
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x .045
Modular/Manufactured Homes... ...$50.00
Receptacle/Switch Outlets
Fixtures ( 7 x $.75
Smoke Detectors x $3.00
Residential/Commercial Appliance
# Fixed Outlets x $3.00
Motor(s) x $3.00
Power Apparatus (220 Volts)
# Apparatus x $5.00
/;;7 76
Permit Issuance Fee...... ........... ...$20.00
c7o,OO
3;2. 76
Total
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: \-.55, h I~
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
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BUILDING INSPECTION REPORT
~:~:tITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION-
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NAME OF OWNER I, i
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CONTRACTOR-
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DATE INSPECTION REQU~S~ED' ""ct::' - c",:;" {) ,!:1
TIME INSPECTION REQUESTED'
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PERMIT NO'
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUlLDING:".,5l.;;~FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
ft F~ED
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
P ASSED FAILED
D D
NOTES/REMARKS'
d7ri~lJr-3;38
DATE OF INSPECTION MADE:
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
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May 2, 2008
Jeff and Leanne Willis Fence and Garage Agreement
RE:141 N. 21st Street, Blair
N ~ Lots 1 & 2, Block 99, Blair City
A 6' fence currently exists on the above property which has been placed on the city right of way
without a permit. The property owners hereby agree to remove the fence in question and/or lower it
to a 4' fence, relocating it within their own property boundaries or getting a fence easement from the
city to have it in the right of way.
One of these actions will need to be completed prior to a final inspection on the proposed garage and
the return of the building permit deposit. Further, it is understood the issuance of a building permit
for the garage is conditional upon signing this agreement.
If your understanding is as set forth in this letter and you are in agreement with these conditions,
please sign and have notarized below. City hall staff will be glad to notarize this for you, if
necessary.
We, the undersigned and owners of the property located at 141 N. 21 st Street, Blair, hereby
acknowledge receipt of a copy of this letter and agree to its terms and conditions.
Dated: May 2, 2008.
CITY OF BLAIR
By 7iP ~
Phil Green, Assistant City Administrator
STATE OF NEBRASKA
)
) :ss:
)
COUNTY OF WASHINGTON
The foregoing instrument was acknowledged before me on May 2, 2008 by Phil Green, Assistant
City Administrator
GC\I8W. MnMV. sum at Nebraska
t'!,. KATHERINE D. LOUDNE
, '~=>;~:,: Comm. Exp, June 17, 2
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Notary Public
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Residential, multiple family _ Residential, one- and two-family
Residential, care/assisted living facilities
Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous_
Is buildinJ! reauired to be protected bv 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:
BuildinJ! Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
All other permits valued under $10,000 No Deposit Fee
Permit fee is:
Finished sqjft area
(not including finished basement area)
Finished basement sqjft area
Unfinished basement sqjft area
Garage sqjft area
Total Valuation:
X $88
$
$
$
$
$
$
$
$
X $53
X$26
X$20
Total Valuation
Multiplied by 0.0056 =
Issuance Fee:
20.00
Total Permit Fee = DepositjPermit Fee/Issuance Fee
Jeff Willis,
.--'
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Leanne Willis, Owner
STATE OF NEBRASKA )
) :ss:
COUNTY OF WASHINGTON )
The foregoing instrument was acknowledged before me on May 2, 2008 by Jeff and Leanne Willis,
husband and wife.
I"~ GENERAL NOTARY - Stale of NebraSka
, KATHERINE D. LOUDNE ,
My comm. Exp. June 17. 20;
j/'Y)d,j/l Q ,I) '-At., D LOU(D1.RJ\.
Notary Public
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RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Business/I ndustrial/Educational/ Assembly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Buildin~ Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
All other permits valued under $10,000 No Deposit Fee
Construction Valuation will be computed bv Sq/ft area X $60
Accessory Buildin2s & Interior Remodelin2 Proiects will be computed bv Sq/ft
area X $40
Permit fee is:
Finished sqjft area
Finished sqjft area
/L?5
X$60
X$40
$
$ -z-C\ /2.0.00
$0 TO $49.............................................................................................. $0 (plus Permit Issuance Fee)
$50 TO $9,999............................................................................................ $50
$10,000 TO $99,999............................................................................................$50 + $6 per additional $1,000
$100,000 TO $249,999......................................................................................... $590 + $4 per additional $1,000
$250,000 TO $499,999............,'......................................................................... $1,190 + $3 per additional $1,000
$500,000 TO $999,999......................................................................................$1,940 + $2 per additional $1,000
$1,000,000 AND OVER ......................................................................................$2,940 + $1 per additional $1,000
Permit Fee calculated from chart above
$ } loS- C>C:>
Issuance Fee:
$ 20.00
$ 1'6CS-.O~ -t 5-00.00
Total Permit Fee = Deposit/Permit Fee/Issuance Fee
Additional Comments:
Approved Byo. \j~~a;i3
Date: ..~"-- /s-k&
I /
Contingent On Approval by Fire Marshall
Meet IBC, IPC, IMC and NEC Code Requirements Y(
Sleeping Rooms below Story and in Basement required to have egress
For Office Use Only
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
CITY OF BLi\IQ
-y ,\~
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IV/,: 6:-'
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BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected at the time of your building
permit application for all commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater. 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)No stop box location card submitted, (with new service only)
3) all required inspections have not been obtained,
4) occupancy occurs prior to a final inspection,
5) all permits have not been obtained,
6) 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.
bw/uU
City of Blair -
5/rdu{
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EQUALHOUSINlIo
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cilyofblalr@ci.blair,ne,us """'"''
CITY OF BLAIR
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 2006 International BuildinQ
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.
!
Contractor
~dAhJl,
Da1f1~) 8r
~tSr-
218 South 16th street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci.blair,ne,us i~~'":~~:~~
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BUILDING INSPECTION REPORT
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LOCATION OF INSPECTION'
NAME OF OWNER ( ./ dI /;~J~
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DATE INSPECTION REQUES{ED' S - .5- - (/8
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UTILITIES: 0 SEWERTAP 0 SEWER 0 SEPTIC 0 WATERTAP 0 REMOTE 0 WATER SERVICE
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COMMENTS:
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NOTES/REMARKS'
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