BP13072
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Blair Building Permit Detail
Permit #: 13072 Issued:
Completed:
Location: 2510 Hollow Rd
Owner: Henry Neef
Address: 2510 Hollow Rd
09/08/2008
12/29/2008
Type: Accessory Building
Valuation: 23040
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
Blair, NE 68008
Phone: 402 426 3648
Section:
Subdivision:
24x24 detached garage with 4/12 Roof Pitch.
Township:
Range:
Lot:
Block:
Contractors
SELF
SELF
Remarks
General Contractor
Electrical Subcontractor
Permit #
E2946
Inspections Date By
10/01/2008 OEM Footings Fail
10/02/2008 OEM Footings Pass
12/29/2008 OEM Electrical Final Pass
12/29/2008 OEM Final Inspection of Project Pass
JAM 0 E
128
20
500
23100
Issued
09/08/2008
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit #
13b1~
:7JiWl
Date:
q 1<6 ~ 0 ~
Approximate Completion Date:
\
Site Plan Attached:
i
REScheck Attached:
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Complete Plans Attached
Application for: Residential Commercial/Industrial
New Construction Manufactured Home Modular
Move-on: Home Accessory Building Other
Remodel Addition
Accessory Building: Garage X
Floor Type: Dirt
Pole Barn Other
Concrete ,X 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 _
Addition.a Description of project if necessar :~L\ 'f-Jd. L{ 1J.L \-. G,~
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Proiect Information:
Job Address:
Legal Description (if applicable) iJ Ii) Yt/
Owner: \-\tit\1j Nee.f-
Contractor: <?:l. \ f-
~S\D
HnllDW RC\
Address:
~hLJl-
89'00/1551
g-IIII.RB Pd Itvtl(}A~
Phone#:tt).(o .3bLt&'
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.
t.~e
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ZONING REVIEW:
Zonin Flood Plain U i1ities:
Current Zoning: Conditional Use Permit Required: Yes _ No ~
Date CU~ J?Pproved:
State Fire Marshal Required: Yes _ No ~ Variance Required: Yes _ No _ .
Minimum Setbacks: Fron~ Second Front Side 2.s--Side _ Rear---zs--;
lot Sauare Footat:!e: L
length x Width: lot Coverage % rj
Driveways/Sidewalks: ~/
Sidewalk required: Yes_ No -u"\\\' Sidewalk Waiver: Yes _ No
'\ \\ Date Waiver Approved:
Flood Plain: Yes __ No
If yes, specify special requirements:
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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 Footat:!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, librClries, 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 buildin~ 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:
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
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 ndustrial/Ed ucational/ Assem bly/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 $ 500 ,t?O
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 Buildin2:s & Interior Remodelin2: Proiects will be computed bv SQ/ft
area X $40
Permit fee is:
Finished sqfft area
Finished sqfft area
_~'i~
X $60
X $40
$
$ c93J 04-0. 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
$ I :)8. 0 0
Permit Fee calculated from chart above
Issuance Fee:
$
8 00
20.00 -:;;. I Lf ;
{j '-Ig. 00
Total Permit Fee = Deposit/Permit Fee/Issuance Fee
$
Additional Comments:
Approved by:.- natL {~ate:
9,dkb'
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:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
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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ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 E 2946
(402) 426-4191
Application Date:
0l>>ldS
Permit Fee: de; ~
...
~ 5"1 0 1-+0 Lt0~>
N eJLtril Address S~ VnJL
Mail Address
Ownfr I A ..--.
1. tit..4 I
~~nlrbt [.f
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL 0 REMODELING/ADDITIONS 0 UPGRADE SERVICE
Describe Work:
4.
5.Current License on File 0 Yes 0 No 0 N/A
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 additional100 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.
7,~-cf}f)
Date
~
Zip
Phone
Zip
Phone
Completion Date
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
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
Receptac1e/Swi~ch Outlets
Fixtures &::/ 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
Lf .so
Permit Issuance Fee.................. ..$20.00
o1{J. 00
Total j;z. SG
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: K Loud~
CITY or BL1\IQ
HOMEO'VNER VERIFICATION FOR ELECTRICAL WIRING PERMITS
if 0'\ (~ Nee 1-
print your full nam on hne above:
, states the following:
1. I am the owner of the single family dwelling for which I am applying for an
electrical permit.
Address: :J S,-/ 0
l--b it" ~ fld
. 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 2005 National Electrical Code requirements to
malce 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. By signing this form I am stating the above information is true an correct.
H~oo?L!fi~~'
Date
7--. /1 - ?J f3
218 South 16th street. Blair, Nebraska 68008. 402-426-4191 . Fax 402-426-4195 . E-mail cilyofblair@ci.blair.ne.us
@-
EOt/ALIIOUsmO
OPPORTUNITY
CITY OF BLNQ
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.
(I JI
Contractor/Owner
Contractor/Owner
City of Blair
c; ~((-(;? &
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cifyofblair@ci.biair.ne.us
EOU.llflOUSlJlG
OPPORTUNITY
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BUILDING INSPECTION REPORT
Q' CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
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NAME OF OWNER' /v//,'//.
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CONTRACTOR'
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TIME INSPECTION REQUESTED'
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PERMIT
DATE INSPECTION REQUESTED'
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D CONFERENCE
D STATUS CHECK
P~ED ~
TYPE OF INSPECTION
BUILDING: FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
COMMENTS:
UTILITIES: D SEWERTAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED F AlLED
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 RADIANT HEAT 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
PASSED FAILED
D D
COMMENTS:
NOTES/REMARKS'
ItJ_~ 30 If/Y?
D OCCUPANCY GRANTED
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ATE OF INSPECTION MADE:
TIMF' I():-S-S-
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INSPECTO
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FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
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BUILDING INSPECTION REPORT
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J2j:(CITY OF BLAIR
LOCATION OF INSPECTION 0
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NAME OF OWNER' J76~11/V0.: /\,{j.J!./~'
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DATE INSPECTION REQUESTED' / () - Z --'D8
D WASHINGTON COUNTY D OTHER
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CONTRACTOR' ';;:jcC..-t,FI~
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TIME INSPECTION REQUESTED' le].- 30A'V-/t. PERMIT NO' /3<::) 7 ;;;:7.
~SPECTI9N~QUESTED:...~~_ ". _ """'~=_, D C,?NFERENCE
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BUILDING: ,;g;J....FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
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COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
D ~TATUS CHECK
;r F[jED
COMMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
D PARTIAL
PASSED FAILED
[J D
COMMENTS:
PASSED
D D
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MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D 0
COMMENTS:
PLUMBING:
D D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
o PRESSURE TEST
PASSED FAILED
D D:
COMMENTS:
o Q~CUPANCY'Gl{'WTED D CONDITIONAL OCCUPANCY GRANTED
NOTESJREMARKS'
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gf~'~ITY OF BLAIR 0 WASHINGTON COUNTY 0 OTHER
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LOCATION OF INSPECTION' j;<::~)/l-.) r7trLf/ot.<.) ;Co.
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NAME OF OWNER'. ',.z.n./u,.,f... IV u!j;y;....~/ CONTRACTOR' (< ) ,~i!.-J.~f-.J
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DATE INSPECTION REQUESTED' / ",~l 0 ,) r:-j1_ 0 b TIME INSPECTION REQUESTED' J /,' ,,30/1/,,/, PERMIT NO'
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE 0 STATUS CHECK
~~- ...~~.".".,.."",=:r'"~=~~~~~
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL ~INAL 0 PARTIAL FAILED
0'
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
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PASSED FAILED J
o 0
COMMENTS:
LA......- ........,.~-..........-""'""""'~~. ~u:;.:a:'l.:i/~~'l=aill:lt;IZ\l:~:;:nc;6:ra::~3:zc:r:~:.:~.~"1:lll:,.~.....r..==.........~~~
ELECTRICAL: 0 ROUGH :gt~FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
P%D F~ED
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MECHANICAL:D ROUGH-IN 0 Ale 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o 0
PLUMBING: D GROUNDWORK 0 ROUGH-IN
[J .' PRESSURE TEST ' .
COMMENTS:,.., ,..".. .'. .. ',.. ',' C,,c".. ,
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FINAL o WATER METER INSTALLED 0 PARTIAL
pASSED FAILED
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NQTES/REMARKS'
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