BP13123
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Blair Building Permit Detail
Permit#: 13123 Issued:
Completed:
Location: 272 N 21st St
Owner: Matthew Rasmussen
Address: 272 N 21st St
11/21/2008
1/13/2009
Type: Siding Permits - All types
Valuation: 7000
Blair, NE 68008
Phone: 657 1969
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
40
25
50
23479
Section:
Subdivision:
Township:
Range:
Lot: 15
Block: 95
Pulled off Existing siding and replacing windows. Replaced siding and replacing windows. Replaced front and back
door. Heat pump and electrical panel and new wiring for furnace.
Contractors
Rasco Homes dba Team Rasmussen General Contractor Permit # Issued
Air Pro Htg & A/e Inc. Residential Heater Subcontractor M1816 1/13/2009
Wiggins Electric Electrical Subcontractor E3048 12/16/2008
Remarks
1/12/2009 OEM Electrical not complete. Smoke alarms required.
Inspections Date By
12/16/2008 OEM Electrical Permanent Service Pass
12/16/2008 OEM Electrical Rough-ins Pass
1/12/2009 OEM Final Inspection of Project Fail
1/13/2009 OEM Mechanical Final Pass
1/13/2009 OEM Electrical Final Pass
1/13/2009 OEM Final Inspection of Project Pass
01-13-2009 13:34 AIR PRO
~
PAGEl
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair; Ncbf:aska. t 3 I d 3
218 South 16th Street (
Blair. Nebraska 68008
Fax (402) 426-4195M 1816
(402) 426,,4191
Appllcl\tlon Date: J ... / 3 - c> Gf_
Job Address
Heat Pump J..!f Tons
Central Ale Tons
Furmtce BTUlH
# of Un lis Ale
FlImMe
Completion Date:
Boller Chart
~TU ~
Up to 100,000..",...,.......,....... ,,,. "..$15.00
100,000-'00,000", n..".'...... ,........ ....$30,00
500,OOO-l,OOO,OOO..'..n" ,__...... 'mm. .$40.00
1,000,000"1,750,000... n".. ,n u um. __ __$60.00
Over 1)7~O,OOO...... ..".. "...,... ..... ,...$100.00
Notice
I hereby ec:rlity that I have read and exmnined this
application and know Ule SlIml) 10 be tmil and correct All
provisions of It.WIl and ordilllll'lct':$ govollling tfli$ tYP~ of
work will be llQmplled with whether $pecifil'ld herein Or
Ml. The at~miog of II P(\\'mlt does not prestJ.1'M III gIve
authority to violat:e or cancel theprovisi<lns of ~ny (lthor
$tate or local law regulating constnlctlon Or the
CJfQ f cons ctiPl)..
1--/3~" 09
ThIrd
6fS. 0 {)
Pcnnit he: $ .
I.
Zip
Ph071t
PhlJi".q/p
o Addition 0 ReI lIc::emant
/.6 y~ a+1d ~..i1I1t1W1~
MECHANICAL PERMIT FEES
dp . t)()
Fumac:elHel\t Pump/A it Conditioner (PfT Unit) ~
Up to "nil inclUding 100,000 BTU 13Ton......m..__un.m'__.,..$15.00
FumAcelHeftt Pump! Air Conditioner (Per UnJt)
Over 100,000 gTU /3 Tlln...uu__um__m..........,........,......$2S,OO
RefrI&ftitior'l Ofjit$/CoolcralLinc8lCompt~saor - Cormn~l'eil\l
(New 01' Replacoment) (Fer Utlit)
+1111f 1.. .., "i"''''' ~ r~" ,..,.. ."",,,' --" ..-_... __a ...... _.... _____ _ _.~.._. ....$15.00
Bollel' (f($I1 BTU Chari to J~./f)u, m........... h.
Appliance Vent/f'ans...... 'u......... ,.....$10.00
. Duct System...... ....,.. ..... ............. ...$1 5.00
Gu/Air Ol.ltleta.................FIrst S _ X $6.00
,.... ....Addltional
x $1.00
R.adiant HflIlt Sys~rn5/GasIW,,~r
Pi in Stem.......................".... ...$50,00
. Modular Home.........,.. .__......m....... $50.00
Permit l$s'Uance l'ee...... ,..... __....... .... .$2$,00
Total
Current Li~enae on File lI1es 0 No CJ N/A
Commont:
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WHEN PROPERL Y V ALIDA TED IN THIS SPACE THl8 IS YOUR PER1v:IIT
Approved By:
01~13-20e9 12:38 AIR PRO
Rev, 2008.10
PAGEl
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 M 1816
(402) 426-4191
Application Date: j- I 3 - 0 <1
Job Address
7d
'1gtj/)
Heat Pump
Central A/C
'Jla t ?tt YI
;.5
Tons
Tons
Furnace
BTU/H
AlC
# of Units
Furnace
Completion Date:
Boiler Chart
BTU Fee
Up to 100,000.............................. ..$15.00
100,000-500,000... ... ......... ... .......... ..$30.00
500,000-1,000,000... ...... ........ .......... $40.00
1,000,000-1,750,000......... ... ........ .. ..$60.00
Over 1,750,000................... ....... ....$100.00
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
. c.55 oD a
PermIt Fee: $ .. 7(0 .
1.1. c.? / Sf- J' /-,
Zip
Phone
r <21.
()/)r1~a ~8117
, Ph7... 96155
o New 0 Addition 0 Alteration 0 Repair 0 Replacement
01101 /!.ki 1ltU1~
MECHANICAL PERMIT FEES
dt> . ()tJ
Furnace/Heat Pump/Air Conditioner (Per Unit) ~
Up to and including 100,000 BTU / 3 Ton.. ....................... ...$15.00
/6
Ytn?
Furnace/Heat Pump/Air Conditioner (Per Unit)
Over 100,000 BTU / 3 Ton.......................................... ...$25.00
Refrigeration Units/Coolers/Lines/Compressor - Commercial
(New or Replacement) (Per Unit)
. . . .. . .. . .. . . .. .. . .. . .. . .. . .. . .. . .. . . .. . . . .. . . . . . . . . .. .. . . . . . .. . .. . . .. .. . .. . .. $15.00
Boiler (use BTU Chart to left)............. .......
Appliance Vent/Fans......... ... ...... .. ....$10.00
Duct System... ... ... ... ... ... ... ... ... ... ....$15.00
Gas/Air Outlets.................First 5
x $6.00
...... ...Additional
x $1.00
Radiant Heat Systems/Gas/Water
Piping System... ... ... ... ...... ...... ....... .$50.00
Modular Home,.. . . . . .. . . . .. . ... . .. . .. . .. .... $50.00
Permit Issuance Fee... ... ... ... ,.. ........... $25.00
Total
d?5. ()tJ
',00
Current License on File :&Yes 0 No 0 NjA
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: e.g. fJJ I dIY~
Rev. 2008-10
.~ 3 ~~ - ~aMJ1~tJJ/nol(}uJ-(p
t CITY OF BLAIR - MISCELLANEOUS BUILDING PERMIT ,1 Q
Permit I l3/d-.)
Date: if - ;2;.-ob Approximate Completion Date: I ~ /.- {) 9 Site Plan Attached:
Estimated Valuation of Project: /tt#! 71/00< dc?
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Application for: Permit Fee $40 + Issuance Fee $25 + $50 Deposit
Fee: $115.00
Egress Window (floor plan drawing required)
Fences (plot plan required)
Gazebos (plot plan required)
Patios/Driveways/Sidewalks (new or replacement)
Roofing/Siding/Soffit and/or Eave Repair/Gutters .X
Swimming Pools with Fence (plot plan required)
Window/Doo'r Replacement (size change only) Y
Miscellaneous Building Permits (items not covered by one of the above)
Description:
Utility Excavation and Curb Grinding
Curb Grind
Length
Utility Excavation
Length
Type: Water
Fee: $75 plus bond
Un. Ft.; Width
; Sewer
Un. Ft
; Other
Amount of Bond Posted: Bond Check I
(Curb grind - $9.00 per Un. Ft.; Utility Excavation - $6.00 per Sq. Ft.)
PROJECT INFORMATION:
JobAddress::J7;? ;J ;7/ SI- cS'f. 89oot.f7Lf-39
Legal Description (if applicable) 1St.!.- ~ t- /5 $I /L. 95 / /Lf Pe 1+
Owner: 111rJi6btJ 7CUl/J11~ Address: Phonel: 05/7 ~/9/t19
Contractor: 1/11 7 aLJ{?t'1 !#f71Ja) Phone I:
Address: /;:; 000 /{1 1'''.../ e (J/;/ Cell I:
() vi'!'] clfi r:~ fJ g ( 5 Lf
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PERMIT RENEWAL FEE:
This fee is based on the amount of the original permit fee and is charged when work is not
completed within two years and the permit expires. Renewals will onlv be allowed with the
stipulation that all exterior site work and outside finish work is completed and interior life-
safety issues have been properly address. Permit renewals are for one (1) year, with a
maximum of two (2) renewals for a maximum permit span offour (4) years.
Original permit fee of $0-$50,000 $100.00 $
Original permit fee of $50,000 - $100,000 $150.00 $
Original permit fee of $100,000 - $500,000 $250.00 $
Original permit fee of $500,000 or more $400.00 $
Issuance Fee:
$
25.00
Deposit:
$
50.00
Total Renewal Remit Fee = Permit Fee + Deposit + Issuance Fee $
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.
1(~1\~O~
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( ignature of Owner/Contractor
Date
For Office Use Only
WHEN PROPERLY VALIDATED (BELOW) THIS IS YOUR PERMIT
Date Permit paid:/-I ~;?I'" {) [/ Receipt # ~.q tf71 Approved by:
..15, rJJr~ (
ruJJab71J~
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
CITY OF BL1\IQ
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.
(7(#-
Owner/Occupant Contractor
City of Blair
! (- ~ \ - 00
Date
tS)-
EQUAL HOUSmG
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@ci.blair.ne.us "''''""'''
.. ~
ELECTRICAL P:JtRMIT APPLICATION .. '3
Jurisdiction of City of Blair, Nebraska 1"J.... \ d
218 South 16th Street \ :-;
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:
/;;J -IIP-v8
Job Address
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E 3048
Permit Fee: $6 Lf. 00
J..7:l
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Zip
~~ne'f/natl &',5 /} _Ph rtJ
Contractor; , ) - Zip '_/lA Phone -
2. {/-/.../ 0..2 7? ;<J.. /;? 9'ffl A~ & {!eft 0/1 a (flg;;
3. Class ofWor : NEW RESIDENTIAL 0 NEW COMMERCIAL ~EMODELINGjADDITroNS 0 UPGRADE SERVICE
Describe Work: , .('1 ,/) /, I .
4. atVn ~....Mt/..L'~ h Y/()uh f /Zt7/n.IJ ~UJ.).h, -tt'k/tft7C
5.Current License on File c:g''ye 0 No 0 NjA Completion Date
Service Fee = (Amp Fee + $5.00 per branch circuit)
1-100 Amp Fee.................... ...$25.00
101-200 Amp Fee.......................$35.00
201-300 Amp Fee... ...... ............ ..$55.00
301-400 Amp Fee.................... ...$75.00
401-500 Amp Fee.......................$95.00
501-600 Amp Fee...... ............... $115.00
601-700 Amp Fee................... ..$135.00
701-800 Amp Fee......... ...... ...... $155.00
801-900 Amp Fee.....................$175.00
901-1000 Amp........................ .$195.00
IF OVER 1000 Amp
1st 1000 Amp Fee..................$195.00
Each additional 100 Amps...... ...$20.00
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.
Date
ELECTRICAL PERMIT FEES
Upgrade Existing Service............ .$25.00 ~
Temporary Service.. .. .. .. .. .. .. .. .... $15.00
Fire Alarm System... .............. ....$15.00
Signs (each).. . ....... .. . .. .. .. .. . .. ......$25.00
Miscellaneous Apparatus......... .....$15.00
Commercial/Multi Family and All Upgrades:
# of Circuits x $5.00
Amp Fee 35, 00
Amp Fee + Circuit Total
New Residential: (Finished Area)
Single/Two Family Dwellings
sq. ft. x .063
Modular/Manufactured Homes...... .$50.00
Other: (alterations, additions and modifications)
SlJ.6U
Receptacles/Switches/Lighting Fixtures (110 volt only)
# of Apparatus.. .. ..... . x $1.00 4--. 0 0
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors. . . ..
x $3.00
.J 0
Permit Issuance Fee.................. .$25.00 cPO ' CJ
, ;/ dO
Total {j '-(.
Comment:
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: (Sf.?.l f ~
I
Rev. 2008-10
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BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
A $200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
The City reserves the right to not refund this deposit if any of the following
conditions occur during the construction period:
1) Theft of water service by the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection.
5) The project is completed without a final inspection being done.
6) Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
I hereby agree to the above conditions, and understand that should any or
all of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
contract1E -
Contractor/Owner
City of Blair
o /f21'()!f
Date
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BUILDING INSPECTION REPORT
/
~ CITY OF BLAIR
"
D WASHINGTON COUNTY
LOCATION OF INSPECTION'
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NAME OF OWNER 7/, (,. r
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DATE INSPECTION REQUESTED' "" - (.I) - c. t>
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TIME INSPECTION REQUESTED' /,'.3 0,,0 III'
V
PERMIT NO'
I~/ 7'7
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TYPE OF INSPECTION REQUESTED:
-- -'e-~ r ...~..........
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
D CONFERENCE
D STATUS CHECK
~..~~~~
CO:MMENTS: '
,!:7
PASSED FAILED
D D
ih.i........~
..,...~IIllZ1I........l''''''''''''",........,"'I$!7~,,_,__..,_
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UTILITIES: D SEWER TAP; D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
COlvThfENTS:
ELECTRICAL: ~ ROUGH IN D FINAL
. ~D PARTIAL
CO:MMENTS:
PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
CtdO ().? P b.
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADlANTHEAT D FINAL D PARTIAL
~~.."""''''''''''"''''.,~~-~.-
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COMMENTS:
PASSED FAILED
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PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
'" '. D PRESSURE TEST
GQ~E.Nts: ..... _ . _ "
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BUILDING INSPECTION REPORT
o CITY OF BLAIR
o WASHINGTON COUNTY
LOCATION OF INSPECTION'
NAME OF OWNER" e q ~. fit" I..<\. ). S e: h,
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DATE INSPECTION REQUESTED'
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~~~~..-.,. ~~..:r~~~~~~"=nn~~-""""""'-"~....:l:;,..~~~-",,--=~~
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL '~FINAL 0 PARTIAL . PASSED FAILft
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o PARTIAL' 0 0
COMMENTS:
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ELECTRIe~L: D ROUGH IN~gJ~FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
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PASSED FAILED
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ET'~CITY OF BLAIR
D WASHINGTON COUNTY
D OTHER
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'" O.a1:n t,{~!}..)2/n CONTRACTOR' /' hJ L C /", (;'l,::)/In U,{J.(j.L I~
- I 3 .,- 0 '1 TIME INSPECTION REQUESTED- ,,3 " 3 {) p, 111 ' PERMIT NO' 1,3 { :L3
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TYPE OF INSPECTION REQUESTED: D CONFERENCE D STATUS CHECK
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BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL? FINAL D PARTIAL P~ F~ED
COMMENTS: (
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UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE PASSED FAILED
D PARTIAL' D D
LOCATION OF INSPECTION'
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NAME OF OWNER- "1' / .I a rz
DATE INSPECTION REQUESTED' I
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CO.MMENTS:
ELECTRICAL: D ROUGH IN::&:FrnAL D
D PARTIAL
SERVICE D TEMPORARY SERVICE D PRECONNECT
~ F~ED
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CO.MMENTS:
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MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANT HEAT D FINAL D PARTIAL
PASSED FAILED
D D'
PLUMBING:' D" GROUNDWOiu<
o PRESSURE
FINAL' 0, WATERMETERINSTALLED D PARTIAL
PASSEl;> FAILED
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