BP13038
Blair Building Permit Detail
Permit #: 13038 Issued:
Completed:
Location: 3020 College Dr
Owner: Taryl Wolgan
Address: 3020 College Dr
7/25/2008
9/2/2008
Type: Residential Additions
Valuation: 6720
Blair, NE 68008
Phone: 426 2234
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
Section:
Subdivision:
12x14 Patio Room
Township:
Range:
Lot:
Block:
Contractors
Better Living Patio Rooms of Omaha
WhiteTail Construction
General Contractor
Electrical Subcontractor
Permit #
E2930
Remarks
Inspections Date By
8/4/2008 OEM Footings Pass
8/19/2008 OEM Electrical Rough-ins Pass
9/2/2008 OEM Electrical Final Pass
9/2/2008 OEM Final Inspection of Project Pass
50
20
200
22890
Issued
8/18/2008
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit# I :xJ38
Date: '7-,;J :::S'~ 08 Approximate Completion Date: /J - CJ-5' - oc}
Site Plan Attached: X' 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
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 _
<-;;
A+rr /~0J?'7
Additio1]al Des,cription of project if necessary:
c.'? cleM tl-n _ Wd/ J7a 1/ .1
Ihll )fIll"
f ,tIp /7../../1../ {di.
Proiect Information:
Job Address:
~.
e crab 3?1 05
/1 {) ;J {J (7dJ J CjL
Legal Description (if applicable) pC,; 'Il- 9-~ 10 .- J f3 c_/I
Owner: 'icv~ Al-'1VJ1 !J"J~"'(ddr~:, '3/);;J 0 ~ ff ~, Phone#: <I ZJp -.2:23 t)
Contractor:cj6..Ltfet./ ~'f/PI1J'; iah'cr" Phone #: 5'9;) -;;2 Ot.'O
Address: ItJCJtJfj (~Lt~;; (,Y+-. ~~~#: IJtfo ..)7;;&;5'
C}./Jr7 0./1 c;U Ct, 8 / ;;llJ
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.
~~ ~'~/
Signature of Owner/Contractor
1/ lu'
Pc cr3
7--Z5~(JR
Date
ZONING REVIEW:
Conditional Use Permit Required: Ves _ No_
Date CUP Approved:
State Fire Marshal Required: yes _ No X Variance Required: Ves _ No~
Minimum Setbacks: Front ~ Second Front Side / Side _ Rear~
lot Sauare FootaJ:!e:
length x Width:
lot Coverage %
Driveways/Sidewalks:
Sidewalk required: ves-i- No_
Flood Plain: Ves No
If yes, specify special requirements:
Sidewalk Waiver: Ves
Date Waiver Approved:
No
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: Ves _ No _ Provided on Plans: Ves No
Sleeping Rooms Living Area Other Egress
Sauare FootaJ:!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, librqries, 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 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:
Building 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:
Busi ness/I nd ustria IjEd ucationalj 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
$
~oo ' cu;)
$
No Deposit Fee
Construction Valuation will be computed bv Sq/ft area X $60
Accessory Buildin2:s & Interior Remodelin2: Proiects will be computed bv Sq/ft
area X $40
Permit fee is:
Finished sqjft area
Finished sqjft area
/~/5'
X$60
X $40
$
$ u,72.0,
&0
$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
5D. ()o
$
$ 20.00 '70. " 0
-
$ c970 oD
Issuance Fee:
Total Permit Fee = Deposit/Permit Fee/Issuance Fee
Additional Comments:
Approved bY~ i)A-~
Date:
7ifflM
/ '
Contingent On Approval by Fire Marshall
Meet IBC, IPC, IMC and NEC Code Requirements X
Sleeping Rooms below Story and in Basement required to have egress
For Office Use Only
Date Permit Paid: (' ~~I ~ ()8
Permit Fee: '10.00
Deposit Amount,,!) DD, DO
Receipt # ;; f). Bq D ,''7I,.L <-4 .'
Deposit Paid by for return t&-... 7)..1 r /,J/j ex...,( tI{.u1 c;.~
/ tJ
Building Inspection Pouch given: Yes JL No_
:;] I/o 2hY7?~
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;
ELECTRICAL PERMi~ l~~~ICATION
13038
E 2930
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
, (402) 426-4191
Application Date:
8~/8 "08
Job Address
3o:)()
Permit Fee: $
dJlI, 15
Phone
Owner /. J M~ Address
I, tV Ci-l" , {J47
~~ntractV~i cJ M 'lL\ddreSI'-'U( a d71 / ;?O /8 {lb ~d ? 30 ~a2on~c5oCJ8
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL ~REMODELING/ADDITIONS 0 UPGRADE SERVICE
Describe Work: A ~ A 1 f " 1 (J
4. CV' ~.r vU c U t/4V/ CJ V\.J
5 . Current License on File Completion Date
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
1st 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.
~ ~::::::>
ure of Contractor or Authorized Agent
ELECTRICAL PERMIT FEES
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
CommerciallMulti 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 :5 x $.75
Smoke Detectors x $3.00
Residential/Commercial Appliance
# Fixed Outlets x $3.00
Motor(s) I x $3.00
Power Apparatus (220 V oIts)
# Apparatus x $5.00
.-? '76
,-J
-3 00
Permit Issuance Fee.................. ..$20.00
~t1, 0 CI
Total 01 t/, 76
Comment:
WHEN PROPERL Y VALIDA TED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: c t?, D
_71 TJI..iUath
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVJD OF:
ADDRESS
CITY, STATE, ZIP CODE
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair,_NE 68008
TYPICAL FRONT WALL CONNECTION DETAILS
TYPICAL SIDE WALL CONNECTION DETAILS
r122
123A i
123A123B i
2-#8x3/4" SDS@ends
1/4"x3" Lag Screw@12" .
#8x3/4" SDS@6" (Alternate 1) .
#8x3/4" SDS@3" (Alternate 2)
90 MPH WIND TABLE
EXPOSURE B
Fastener Qty/Spacing
Sect, Fastener* Type Room Size
10'x10' 15'x15' 20'x20'
F1 #8 x 3/4" SDS 4 9 14
122-D F2 1/4" Diam. Stainless Steel Lag Scr<./2" Emb,.. 2 3 5
F3 1/4" Diam, T apcon/1-3/4" Embed. 2 5 7
F3 #8 x H/2" SDS 4 9 14
123-A F4 #8 x 3/4" SDS 4 9 14
123.B F2 #8 x 3/4" SDS 18" 18" 15"
123.C F4 #8 x 3/4" SDS 4 4 5
Fl #8 x 3/4" SDS 4 4 5
123.G F2 114" Diam. Stainless Ste,1 Lag Ser../?:' Emb,.. 1 2 2
F3 1/4" Dlam. T apcon/1-3/4" Embed. 2 2 3
C>
Z
g
:3
OJ
C>
Z
;::
(f)
x
w
122i 122i
122F
123L 123L
22D
SLAB/DECK
122D
l SLAB/DECK 123F
/~ 122 SECTION 123
~ -v'~/j~ _
< '.' . \. '\" _\~ . CBM Panel
!<'\ ,\\ .>\~x . <>:.,---#8x3/4" SDS@6"
~""~ I
~..':::;:~./> Continuo).!s CE?t0 Silicol')e ) (4).(5)
'<"'" " Seaiant l2" minimum width
. Fastener Type F2
123H
. TOTAL NUMBER OF FASTENERS.
SECTION 123-A
SECTION 122
123~
CBM Panel
#8x1" SDS@24"
#8x1" SDS@24"
I #8x2" SDS@6" at every
door frame sill
= ~~~~~~ "~/~""'1/2" N,HAoch,,@'6"
~ #8x1" SDS@Centerof Unit for Concrete Slab (min, 4/unit)
#14x3" Hex@ every joist (less than 24"o,c,)
for Wooden Deck (min, 4/unit)
Same as for
Section 123-B
_v7~CBMPanel
v .-~ "/\ ~ /.:--- ,'Y;>:< y / \,'.\
'. "c_ .. ".. . CBM Silicone Sealant
Mullion
Fastener Type F4
[II;. I ; hl'-'#&3I4" SDS@24"
I #8x3/4" SDS@12"
#8x3/4" SDS@24"
CBM Panel
#8x1" SDS@Center of Unit
SECTION 123-E
SECTION 123-C
CBM Panel
#8x3/4" SDS@24"
SECTION 123-B
SECTION 122-A
SECTION 122-B
(SECTION 123-D)
SECTION 122-C
(SECTION 123-H)
#8x3/4" SDS@24"
#8x1" SDS@TBM
AI A-Frame Column
(Mullion)
Fastener Type F1
AI A-Frame Column
(Mullion)
Fastener Type F1
1" Diam, Washer
--- AI Flashing
Fastener Type F3
------ --- -AI Flashing
:::::::::: ::::::::::1 ;~'~1-1/2" Nail Anchor @16" for
YHconcrete Slab (min. 4/unit)
#14x3" Hex@16" for
Wooden Deck (min. 4/unit)
for PANEL
KNEEWALL
SECTION 123-F
#8x1" SDS@TBM
:::: :::: :::::::::: :::::::::: --- AI Flashing
------I~/4.~H/2" Nail Anchor@16"for
YHconcrete Slab (min, 4/unit)
#14x3" Hex@16" for
Wooden Deck (min, 4/unit)
for GLASS
KNEEWALL
SECTION 123-F
-#8x1" SDS@TBM
1" Diam. Washer
--- AI Flashing
Fastener Type F2
.~ .'1
SECTION 123-1
!:.;',~i."~"~~~; '.
4-#8x3/4" SDS
i. . . ~ ~ .
-#8x1" SDS@TBM
#8x3/4" SDS@TBM
J: #8x3/4" SDS@TBM
j j ~ 2-#14x3" Hex@TB
1"x6" min,
for
WOODEN DECK
SECTION 122-D
(SECTION 123-G)..
for
CONCRETE SLAB
4-#8x3/4" SDS
SECTION 122-D 4-#8x3/4" SDS
(SECTION 123-J
SECTION123-G) NOTES FOR GABLE ENCLOSURE CONNECTIONS
1, TYPICAL CONNECTION DETAILS FOR VINYL GABLE ENCLOSURE WITH ROOF PANEL SPANS OF UPTO 10 FEET,
4-#8x3/4" SDS 2. DESIGN LOADS BASED ON ASCE 7-02,90 MPH WiND SPEED, EXPOSURE B CONDITIONS AND 40 PSF UNIFORM GROUND SNOW LOAD,
#8x1" SDS@TB 3, STRUCTURAL MEMBERS SHALL CONFORM TO CBM SPECIFICATIONS,
4, ALL ROOF PANELS TO BE ANCHORED TO HEADER SUPPORT BEAM USING MINiMUM 2" WIDTH CBM SILICONE SEALANT,
5. WHERE REQUIRED, APPLY CBM SILICONE SEALi'\NT ONLY TO SURFACES CLEANED USING ALCOHOL
6. ALL ROOF PANELS WITH SPANS UP TO 10 FT TO BE ANCHORED USING EITHER 4-#8x3/4" SDS (MIN.) @36"o,c, FASTENED
. UP THROUGH HEADER ARM AND INTO EACH "H", OR H/4x5" LAG SCREW (MIN,) WITH 3"x3"xO.1" AL PLATE/WASHER
@36"o.c. FASTENED DOWN THROUGH PANELS AND EMBEDDED 2" (MIN,) lNTO AL HEADER SUPPORT BEAM.
#8x1" SDS@TB 7. ENCLOSURES WITH DIMENSIONS LARGER THAN 20'x20' AND/OR ROOF PITCHES OVER 4:12 REQUIRE CUSTOM ENGINEERING,
8. SPACE COLUMNS IN LOAD-BEARING WALLS NO FURTHER THAN 83.5" APART. .....
9. SPACE FASTENERS AT LEAST 2 x FASTENER DiAMETER FROM ADJACENT FASTENERS AND/OR EDGES,
1f.'u~[~~CJ/~~~~g~~~~~~~~TJ~~~3~'UCTS PER LOCAL CODES. ~~OFES~'I<v.;.,'.'tlt.
12, WHERE USED, ASSUME CONCRETE TO HAVE STRENGTH GREATER THAN 2,500 PSI. ~ Z~~"<tb'(("';%
13, MITER ALL FLOOR CHANNELS Ai CORNERS (OR EQUIVALENT). $ cP ;- ,*' ~c'":*
14. NOTCH AND PROPERLY FASTEN HEADER SUPPORT BEAM AND CORNER POST. ..' -., ,
15, ALL STRUCTURAL COLUMNS TO BE CONTINUOUS FROM FLOOR TO ROOF HEADER. PROJECT: tal: dq~
16. ALLOWABLE SiRESS IN AL CONNECTiONS INCREASED BY 3010 FOR wit g ri.,
WIND LOADiNG PER AL ASSOCIATION SPECS. ,,0 g.::o .
17, WHERE REQUIRED, HEADER BEAM MAY ONLY BE SPLICED AT CENTER LINE OF % ,8
STRUCTURAL COLUMNS,
18. AUTHORIZED FOR BETTERLlVING DEALER/MATERIALS USE ONLY,
19, ABBREVIATIONS: MPH - MILES PER HOUR
~~M ~lfR~WB~L T MANUFACTURING o,c. '= 'ON CENTER
DIAM '= DIAMETER PSF,= POUNDS PER SQUARE FOOT
EMBED '= EMBEDMENT QTY = QUANTITY
FT = FEET SDS '= SELF-DRILLING SCREW
H = AL-THERMAL H-STIFFENERS TB'= TOP AND BOTTOM
M.IN '" MINIMUM lBf-1= TOP, BOTTOMAJ>lD MIDDLE
4-#8x3/4" SDS
#8x3/4" SDS@TBM
~ #8x3/4" SDS@TBM
2-#14x3" @TB
1"x6" min,
SECTION 123-K
4-#8"x3/4" SDS
4-#8"x3/4" SDS
Gusset Plate
#8x1" SDS@TB
~ 2-#14x3" @TB
#8x11/4" Lag Screw@24"
#8x3/4" SDS@TBM
for DOOR/
WINDOW JAMB
SECTION 123-L
III' 2-#14x3" Hex@TBM
#8x1 1/4" Lag Screw@24"
#8x3/4" SDS@TBM
for DOOR/WINDOW
JAMB WITH PANEL FILL
SECTION 123-L
- #8x1" SDS@TB
4-#8"x3/4" SDS
Gusset Plate
4-#8"x3/4" SDS
4-#8x3/4" SDS
SECTION 122-F
(at fioor level)
SECTION 122-E
SECTION 122-F
I
. Betterliving Patio Rooms of Omaha V I N YL
10908 Emiline ST
Omaha,NE68128-5725 GABLE ENCLOSURE
CONNECTION DETAILS
90 MPH - EXPOSURE B
4-#8"x3/4" SDS
Gusset Plate
#8x1" SDS@TB
L
=
- #8x1" SDS@TB
~p.
4-#8"x3/4" SDS
4-#8"x3/4" SDS
4-#8"x3/4" SDS
WGNO,:
em40-cn)(-90B-v
E: ',1J14tloo6
--\ifttj!!Ib .. ..
SECTION 122-G
SECTION 122-H
SECTION 122-1
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SIDE WALL (C)
-ASSEMBLY DETAILS
SEE ALLOWABLE LOAD
TABLE FOR PANEL SIZES
B - WALL T BEAM
14'
GABLE FLOOR PLA~AL)
, ALLOWABLE LIVE LOAD TABLE FCS
20 PSF 25 PSF 30 PSF 35 PSF
3"HC
3"EPS+H
3"HC
3"EPS+H
3"HC
3"EPS+H
3"HC
3"EPS+r
NOTES FOR GABI
1. ALLOWABLE LOADS ARE BASED UPON
THE LESSOR OF THE ULTIMATE LOAD/2,5
OR THE LOAD AT SPAN/120.
2. HC/EPS REFERS TO CBM STRUCTURAL
PANELS WITH ALUMINUM SKINS BONDED TO
HONEYCOMB/POLYSTYRENE CORES (3",4112"
AND 6"IN THICKNESS), ADJACENT PANELS
ARE CONNECTED USING VINYL CLEATS OR Hs,
3, NINETY (90) MPH DESIGN WIND SPEED,
EXPOSURE A OR B,
4. DESIGN ROOF PANEL DEAD LOAD = 5 PSF.
5. DOOR AND WINDOW LOCATIONS/SIZES ARE
INTERCHANGEABLE PER MFG'S SPECS.
6, ROOM PROJECTION (A OR C WALL WIDTH) MAY
VARY PER DOOR&WINDOW LAYOUT & RIDGE
BEAM/COLUMN DESIGN (UP TO 16 FT),
7, PANELS MAY ONLY BE USED IN ROOFS
AND WALLS OF ONE STORY BUILDINGS OF
CONSTRUCTION: TYPE VB (FOR IBC/NBC),
JYfE VI (FQR_SBC) AND TYf'gYH(EQ~J.J-'2g~___
A-FRAME RIDGE BEAM OR
GLUE LAMINATED BEAM
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IUFACTURING
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TYPICAL GABLE SECTION:;>
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GABLE ENCLOSURE
GENERAL LAYOUT
19 Patio Rooms of Omaha
1)08 EmiIine ST
ha, NE 68128-5725
I.:
~x14
/14/2006
CITY OF BL1\IQ
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.
~
Contractor/Owner
'] h(!{)~
Date
City of Blair
(5)-
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail c1tyofblair@ci.blair,ne,us ~~~';i-:,'':W~~
CITY OF 5LAII:2
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.
(It(~I~
Owner/Occupant Contractor
City of Blair
7!'SIJob
Date l
(5:r-
EOIJJJ..1l0USWo.
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblalr@cl.blair,ne,us '"""''''''
~~~~~"~~'''''':~~~-.~~~ ~.:..~~...~.~..~~.."""..~..,.""....~-~"",--~..~~~.~~<,~.-~..~~~..-=
BUILDING INSPECTION REPORT
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,tB~CITY OF BLAIR D WASHINGTON COUNTY D OTHER .
LOCATION OF INSPECTIOl,'l' ,,-_:5 c /;7 () (' }tf{!/!j7 OJ! ,i~.4 '
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NAME OF OWNER' /,r;.t;..c,'i,,j-' /-"'1&//-, CONTRACTOR' (~"-j_L~)T'1 d!Jl ()(,L(/c)jVUJi,
DATE INSPECTION REQUES~ED' ~/~rCl:;lt..(~JVJ TIME INSPECTION REQUESTED' 7T~ {) A, ;'\/[ . PERMIT N;-i3 0 3e
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TYPEOFINSPECTIONREQUESTEDT 7 ~ U D CONFERENCE D STATUS CHECK
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BUILDING: ~s:.F6bTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL 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
ELECTRICAL: DROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
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COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PA$~-l'lD FAILED
D D
PLUMBING: D GROUNDWURK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTlAL
D PRESSURE TEST
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CONJ.)ITIONAL OCCUPANCY GRANTED
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LOCA TION OF INSPECTION:
BUILDING INSPECTION REPORT
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NAME OF OWNER-
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DATE INSPECTION
TIME INSPECTION REQUESTED- , '
PERMIT NO- /
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWERTAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
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PASSED FAILED
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COMMENTS:
ELECTRICAL:']:Jj' ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
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PASSED FAILED
D D
COMMENTS:
MECHANICAL:D ROUGH-IN D AIC D FURNACE D RADIANT HEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
DATE OF INSPECTION MADE:
TIME' /1/47
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BUILDING INSPECTION REPORT'
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TIME INSPECTION REQUESTED'
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COMMENTS: P'1. i'\ u it l/I-. 0 0
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UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE PASSED FAILED
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COMMENTS:
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NOTES/REMARKS-
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BUILDING INSPECTION REPORT
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D WASHINGTON COUNTY
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LOCATION OF INSPECTION:
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NAME OF OWNER'
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DATE INSPECTION REQUESTED'
TIME INSPECTION REQUESTED'
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PERMIT NO'
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D STATUS CHECK
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COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
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COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
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MECHANICAL:D ROUGH-IN D AJC D FURNACE D RADIANT HEAT D FINAL D PARTIAL
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D 0
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
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COMMENTS:
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NOTESIREMARKS'
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