BP12984
Blair Building Permit Detail
Permit #: 12984 Issued:
Completed:
Location: 1600 Washington St
Owner: Fernandos
Address: 1600 Washington St
5/16/2008
6/10/2008
Type: Industrial/Commercial - Remodeling
Valuation: 8040
Blair, NE 68008
Phone: 402 533 4450
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
50
20
200
22456
Section:
Subdivision:
Township:
Range:
Lot: 28-30
Block: 37
Adding a women's ADA bathroom to restaurants and adding a wall for locked storage for liquor.
Contractors
Midlands Construction Services, Inc.
Express Plumbing
Hipnar Electric
Remarks
General Contractor
Plumbing Subcontractor
Electrical Subcontractor
Permit #
P1820
E2894
Issued
5/16/2008
5/27/2008
Inspections Date By
5/28/2008 OEM Plumbing Rough-ins Pass
5/28/2008 OEM Electrical Rough-ins Pass
5/28/2008 OEM Framing Pass
6/10/2008 OEM Plumbing Final Pass
6/10/2008 OEM Electrical Final Pass
6/10/2008 OEM Final Inspection of Project Pass
~
Date:
.5'-111 - 08
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # 1;< C; 8 if
Approximate Completion Date: & -' / tJ - 08
~
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 "2:;:' Addition
--------Accessory BuTICling: Garage _ PoleBarn_ Ollier
Floor Type: Dirt Concrete Electricity: Yes _ No
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 _
County Road Permit Required: Yes_ No _ Submitted: Yes _ No _
Proiect Information:
/&(){) WM/;~'~ &1. aqoOlf'
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ion (if applicable) c;fc t~ts r:;;g,'gv ,fj-::'iJ/:',lf 1 /It:; f?C /9
Address: <Sa1n1 tAJ ab,eJtlJPhone#: o33-'-ILl5o
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crnS74t1 'P IJ77 Phone#: u59~ Lj/SO
Cia) /!ad
JltltU IP8/57
Separate permits are required for electrical, p umbing, 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
codesjordina ces 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 r' not completed wit . two (2) years of date of issue.
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Job Address:
Address:
Cell #:
Contractor:
0-/0"- rJrf
Signature of Owner/Contractor
Date
ZONING REVIEW:
Zonin Flood Plain Utilities:
Current Zoning: {\ Conditional Use Permit Required: Yes _ N~
~D te CUP Approved:
State Fire Marshal Required: Yes No _ Variance Required: Yes _ No_
Minimum Setbacks: Front _ cond Front? .Side Side _ Rear_
Lot Sauare Foota~e: IV I 'f-\.
Length x Width: Lot Coverage %
Drivewavs/Sidewalks:
Sidewalk required: Yes_ No_
SldewN H!~Yes No
Date Waiver APProve~
Flood Plain: Yes No ' '.
If yes, specify special requirements: .
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 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, IibrC!ries, 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 buildinJ:! reQuired to be protected by automatic fire sprinkler system?"
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
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Business/I ndustrial/Ed ucational/ Assem bly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Buildinl! Permit Deposit Fee:
Residential additions/remodels/accessory buildings valued under $10,000 $ dO O. CJIV
Fee = $200.00
Commercial, new homes and residential
additions/remodels/accessory buildings valu~d $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 Buildine:s & Interior Remodeline: Proiects will be computed bv Sq/ft
area X $40
Permit fee is:
Finished sqjft area
Finished sqjft area
c-:;/ 0/
X$60
X $40
$
$ 13, () Lf 0 . pi)
.
$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
$ 50, 00
$ 20.00
$ tJ1/J . 00
Issuance Fee:
Total Permit Fee = DepositjPermit Fee/Issuance Fee
Additional Comments:
--------. .~.
Approved bY' j)zti~
Contingent On Approval by Fire Marshall X X
Meet IBC, IPC, IMC and NEC Code Requirements
Sleeping Rooms below Story and in Basement required to have egress
Date:
S~/oC3
I' /
For Office Use Only
Date Permit Pafslj 5: I q-() B
Permit Fee: :ill" ,,7CJ
~:~~;pi~ ~~~~~ . 00 ~J1~1 ,i .11 /17
Deposit Paid bYf~r return to:/ (/./ a.f Ct11 OJ' ( (!JIs-b", {f2t.~
'75a'1 ,/J44ow z,e~
b;.
U-1n all w /JI c!J / 5' '1
Building Inspection Pouch given: Yes _ No
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: ,J)~ III -0 f3
Job Address
Comments:
Notice
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws 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.
P 1820
00
Permit Fee: $ , qIJ.
o Replacement
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PLUMBING PERMIT FEES
Modular Home... ... ......... ... ....$50.00
Type of Fixture No.
Kitchen............................. .$8.00 x
Bath..................... .......... ...$8.00 x ::z
Rough-In Bath....... ... ...... ... ... $4.00 x
Additional Sinks.................. ..$3.00 x
Laundry/Drain............ ........ ..$5.00 x
Water Heater......... ...... ... ......$3.00 x
Outside Water Faucet..................$3.00 x
Drinking Fountain.......................$3.00 x
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Backflow/Grease Trap.......... ..$10.00
Water Service..................... .$10.00
Sewer.............................. ..$10.00
Groundwork..................... ...$10.00
Septic Tank & Laterals........... $10.00
Lawn Sprinkler System...... ......$10.00
Sprinkler System (Commercial). $30.00
Gas/Water Piping System
(Commercial)............... .... ....$30.00
Permit Issuance Fee............... .$20.00
Current License on File
Comment:
Total
~es 0 No 0 N/A
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
!APprovedBY: 3. ?J/~
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
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ADDRESS
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CITY, STATE, ZIP CODE
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS.
NO
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RECEivED BY
Pounds Printing, -Blair,~ NE 68008
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CITY or BLNQ
BUILDING PERMIT DEPOSIT AGREEMENT
A $200.00 refundable deposit is being collected at the time of your building
permit application for all residential additions/remodels/accessory buildings
valued under $10,000. 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,
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.
I/Li
Contractor/Owner
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Contractor/Owner
City of Blair
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Date
(5)-
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci,blair,ne,us ,~~'J-~,O~;~:
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ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska )''1 Cf VO ~'
218 South 16th Street (7
Blair, Nebraska 68008
Fax (402) 426-4195 E 2894
(402) 426-4191
Ownerr ,n \ /\ Mail Address
1. r~~~
Contractor t' Mail Address
2.
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL "'REMODELING/ADDITIONS
4D.escribe Work: ~-'11,'--fj, /) d -Ill II II
()::.e.I'"~ rL Ar~A.~v"11- /l.M1",_'S~
5.CurrentLicense on File 0 Ye 0 No 0 N/A Completion Date
Application Date:
-). I/Jf
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 ofIaws 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 consh'uction or the
performance of construction.
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<;;- 27-C?i
Date
Permit Fee: $ )y ,Si)'Z~
I b 02;
Phone
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Zip
Phone
o UPGRADE SERVICE
ELECTRICAL PERMIT FEES
Upgrade Existing Service.. . . . . . . . . . . .$1 0.00
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 0 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
v: S\)
Pel1nit Issuance Fee.................. ..$20.00
dc)' J)
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Total
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: "\, (f
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1\ \',-, -G V- /
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BUILDING INSPECTION REPORT
o CITY OF BLAIR
LOCATION OF INSPECTION'
NAME OF OWNER' F..e't')."1 C, n J,~
DATE INSPECTION REQUESTED' s-.~~ J-)jl"
o WASHINGTON COUNTY
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o OTHER
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CONTRACTO' Jf...,)( Ill' C":; ~
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TIME INSPECTION REQUESTED'
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PERMIT NO' v t L
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE 0 STATUS CHECK
-- T=~~- ~-._ .___.. ~~..,..",,,..__.. ~~.. ~T"'~"'J;'tr'l.1
BUILDING: 0 FOOTING 0 DECKFOOTING'XfRAMrnG 0 DRYWALL 0 FINAL 0 PARTIAL PASS~ FAILED
COMMEN!:: ~ ~~__ __~~_ ~ '. ~__._.__ .-Z~--~.
UTILITIES: B ~~~~AP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE f!: P F~ED~
COMMENTS:
::z: -~"" _ ___~~W7:~U-1:r~~
,,-
ELECTRICAL='G:V ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
,.~
V,Op ARTIAL
COMMENTS:
MECHANICAL:O ROUGH-IN 0 AlC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
PASSED FAILED
Or 0
COMMENTS:
PLUMBING:
o
o PRESSURE
ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
COMMENTS:
o l?CCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTESIREMARKS'
INS
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DATE OF INSPECTION MADE:
FAXED OPPD\BURTREA
TO CONNECT SERVICE: ON
BY
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BUILDING INSPECTION REPORT
I
8l~ CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
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CONTRACTOR' ///j {j!f~?,j.l7 (:;t~ (,.;.~71 ,5:';:"
TIME INSPECTION REQUESTED' / 0.' () {) A .[1,1 ' PERMIT NO' / (;2<18 ~
LOCATION OF INSPECTION'
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NAME OF OWNER' 1'Ci.141 CZ110hs
DATE INSPECTION REQUESTED' &,; - rf} 0/3
TYPE OF INSPECTION REQUESTED: D CONFERENCE DSTATUS CHECK
~=--=~~~~..J. -~m==~"'~~",,-~,,;,a.&.li~""""'--r,;; ~_ ,~___
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL .~~FINAL D PARTIAL P~ F~ED
COMMENTS: ~
~~ii~&.1':!:att:'~~~~~'lII$lII:\;:m:':$~..e;x:'~2!m=m:.t,..",,,,",,,,,,,,~-=-.,,..,,.,",,,,,,,-...:.L:-- ~~'r="~ "'.
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
ELECTRICAL: D ROUGH
D PARTIAL
D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
P,D F~ED
PASSED FAILED
o D
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN"ct~JNi\L D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
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