BP13132
Permit #: 13132 Issued:
Completed:
Location: 8587 Victory Ln
Owner: Tim Ott
Address: 8587 Victory Ln
Blair, NE 68008
Phone: 426 3725
Section:
Subdivision:
Township:
II lED
Blair Building Permit Detail
12/26/2008
7/16/2009
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Type: Residential Remodeling
Valuation: 21672
Range:
Lot: 4
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
Block: 12
326
25
500
23733
Finishing out unfinished basement. Putting drywall on existing walls, new carpet and electrical. One egress window
exist.
Contractors
SELF
SELF
Remarks
7/9/2009
Inspections Date
2/19/2009
4/15/2009
7/16/2009
7/16/2009
BMP
By
DEM
KAR
HOW
HOW
General Contractor
Electrical Subcontractor
Not done changed completion date to 10/01/2009
Framing
Electrical Rough-ins
Electrical Final
Final Inspection of Project
Permit #
E3074
Pass
Pass
Pass
Pass
Issued
2/24/2009
Partial
Date:
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
, ,(,
Permit # J "7 j c~,A
Approximate Completion Date: c~5- - c5/-U
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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 ~ Addition
Accessory Building: Garage _ Pole Barn_ Other
Floor Type: Dirt _ Concrete _ Electricity: Yes _ No
Sign Erecting, Awnings _ Decks/Handicap Ramps (plot plan required) _
Satellite Dishes/Radio Antenna/Cell Towers (plot plan required) _
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:
Job Address:
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~
Legal Description (if applicable) flutjAJ Ll/YI d &f~
,~
Owner: I', Address:
? S' ?f I
B 900 (j)53~?> I
;;& I-- tf /;1$ pc! t/
Phone#: it) G - J7 )J<--
Phone #:
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 da~_grjSnot.::tflted ,?two~~~~ears of date of issue.
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Signature of Owm{rjContractor
l;2/;6/G)?}
I
Date
ZONING REVIEW:
Zonin Flood Plain
Current Zoning:
Conditional Use Permit Required: Yes _ NO~
Date CUP Approved: ·
Yes _ No L Variance Required: Yes _ No_
Second Front Side Side Rear_
State Fire Marshal Required:
Minimum Setbacks: Front
Lot Sauare Foota~e:
Length x Width:
Lot Coverage % 1\ r I ~/
~
Driveways/Sidewalks:
Sidewalk required: Yes_ No_
Sidewalk Waiver: Yes
Date Waiver Approved:
Preexisting Garage requires driveway to be less than 3' from property line: Yes_
Approved by:
No
Flood Plain: Yes No
If yes, specify special requirements:
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 _
(section continued on next page)
High Hazard HPM
Institutional, incapacitated _
Institutional, day care facilities _
Residential, multiple family _
Residential, care/assisted living facilities
Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous _
Institutional, supervised environment _
Institutional, restrained _
Mercantile Residential, hotels_
Residential, one- and two-family
Is buildin~ 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: 20% grade or less? Yes _ No_
(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:
Buildin~ Permit Deposit Fee:
Commercial, new homes and residential
additions/remodels/accessory buildings valued $10,000 or greater $
Fee - $500.00
Residential additions/remodels/accessory buildings valued under $10,000 $
Fee";' $200.00
All other permits Fee = $50.00 $
RESIDENTIAL - NEW CONSTRUCTION:
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 $92
X $56
X$29
X$25
$
$
$
$
$
$
$
$
Total Valuation
Multiplied by 0.006 =
Issuance Fee:
25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
Businessjl nd ustrial/Ed ucational/ Assem bly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sqjft area X $63
Except for the following:
Accessory Buildim!s & Interior Remodeling Projects: sqjft area X $43
Pole barns with no hard surface floor: sqjft area X $25
Si~n Erecting/Awnings and Decks/Handicap Ramps: sqjft area X $25 (Minimum
valuation of $2000)
Construction valuation computation:
Finished sqjft area
X$
$
Construction valuation is ...................................Permit fee is:
$0 TO $50.......................................................... $0
$51 TO $500........................................................$25
$501 TO $2,000........................................................$25 + $3 per additional $100
$2,001 TO $25,000........................................................$70 + $13 per additional $1,000
$25,001 TO $50,000..................................................... $370 + $10 per additional $1,000
$50,001 TO $100,000..................................................... $620 + $7 per additional $1,000
$100,001 TO $500,000..................................................... $970 + $5 per additional $1,000
$500,001 TO$1,OOO,OOO ..................................................$2,970 + $4 per additional $1,000
$1,000,001 AND OVER ..................................................$4,970 + $3 per additional $1,000
Permit Fee calculated from chart above
$ 3;2fR.otJ
$ 25.00 '" 35l.IJO
$ 85 \ . () c)
Issuance Fee:
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
Additional Comments:
Approved b~: ~ t#~..'
.;r
Date:
I ()/Jo ;06
~
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
I
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ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Owner .--r: a I I
1. /1(\(\ TT
Contractor . 0_ Mail Address
2. ..set .,
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL 0
Describe Work: r 1\ _I ~ .'. I <\'_ n 1-.. __. _ L
4. t:::--ecliU LCL '---rc>I'-- L:.L-A..s~~~ V\.. T
5.Current License on File 0 Yes 0 No 0 N/A
Application Date:
'1-/ Z LI ( oq
Job Address
&6~, V\' LA-ore,
Mail Address
:=> C\... fY\. C'
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
1 st 1000 Amp Fee............... ...$195.00
Each additionall00 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
E 3074
Permit Fee: $
~/ .() 0
e
Zip
Phone
Zip
Phone
REMODELING/ADDITIONS 0 UPGRADE SERVICE
12t..r00 d---'<--I
Completion 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
CommerciaIIMulti Family and All Upgrades:
# of Circuits x $5.00 ::; . 00
Amp Fee
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)
Receptacles/Switches/Lighting Fixtures (110 volt only)
#ofApparatus.......... 11 x $1.00 n/DO
f),OO
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.. ... --j.
x $3.00
~
Permit Issuance Fee................. ..$25.00 2- S ,() 0
Total 47.00
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: b, fA) )~u
Rev. 2008-10
CITY or BLNQ
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HOMEOWNER VERIFICATION FOR ELECTRICAL WIRING PERMITS
It ~ D++-
, states the following:
print your full name on line above:
1. I am the owner of the single family dwelling for which I am applying for an
electrical permit.
Address ~S 8;1 VI c-krlJ La.. '(\~
, 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
make 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 infonnation is true an correct.
~~~
Home/wner/ Applicant Signllilre
JPf(ci
Date
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cilyofblair@ci.blair,ne.us
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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 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.
Contractor/Owner
City of Blair
/:Jh;!u8
I
Date
CITY 0 r BLAn~
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.
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Owner/Occupant/
Contractor
City of Blair
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Date' I'
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@cLblair,ne,us
EQU.l,I.-HO\lSIllG
OPPORTUrIlTY
. ~~"~'BuIEDINli'iNsi>Eci~IoN~iiEroRT""">"".,.
.,-,..,._-..,;c....._._'-'-..."....."'.~,.'--~
J
~ITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
(-' . / /
NAME OF OWNER' ....jL411U t:Jt:C
DATE INSPECTION REQUESTED' 0'7- J "i ~- 0 ~1
,.--" .,..- (-~ I /' . .., / ~/.,
:::;.;.5 f":} / r/ wi {}. 7Pl-~~ CA d4'~
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CONTRACTOR' ~~
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TIME INSPECTION REQUESTED', . ~::.; 0 A lv", PERMIT NO'
/ ::? / "'7-'}
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TYPE OF INSPECTION REQUESTED: 0 CONFERENCE 0 STATUS CHECK
~T :tl:~,i"l""':~.ili-J._A..~- "'" ....l$i;".1 Jl.~ """"'~~~~~11Zi8..~~
BUILDING: 0 FOOTING 0 DECK FOOTING ~~RAMING 0 DRYWALL 0 FINAL ~J PARTIAL FAILED
o
COMMENTS:
UTILITIES: 0 SEWER TAP. 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0
o PARTIAL
PASSED FAILED
o 0
SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
PASSED FAR-ED
o D
MECHANICAL:D~RODGfI~1ND-lJc no FURNACE D~ RADiANTIIEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o O.
COMMENTS:
,PLUMBING: 0 GROUNpWORK D' RQUGH:W 0 FJNAL DWATERMETERINSTALLED 0 PARTIAL
o . PREssurill'fEStL
COMMENTS:: . . . . .... ~">" .~>,j", .
D. ()dj~~Q"i;iA&ri<l) ~~~~~~~.i)ri ?12.. mil.
NOTESIREM~Jtf($'" . 7/f{j,.~~!fdJiYI:7& ~
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PASSED FAILED
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BUILDING INSPECTION REPORT
D CITY OF BLAIR
D WASHINGTON COUNTY
LOCATION OF INSPECTION-
NAME OF OWNER-
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CONTRACTOR-
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DAT~:~l~od~STt! J1),,~.{~ kt~ ~ T~P~!ON ~~~~Ef; :1 ! fl ~dl,' 1V';~~? f ~.?~S
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BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWERTAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
COMMENTS:
ROUGH IN 0 FINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
PARTIAL
~ F~ED
COMMENTS:
MECHANICAL:D ROUGH-IN D NC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
o 0
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
o D
COMMENTS:
D OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS-
/
INSPECI,()R'~ ~
DATE OF INSPECTION MADE:or:-1 S ..~ TIMF- / j.: i/ b
FAXED OPPD\BURT REA
/!:a:
:1d<'CITY OF BLAIR
BUILDING INSPECTION REPORT
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
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NAME OF OWNER /' ~./. /n
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DATE INSPECTION REQUESTED'
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TIME INSPECTION REQUESTED' /i~:), . ,;;/;;;/l7 it/I
PERMIT
TYPE OF INSPECTION
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL
D CONFERENCE
FINAL D PARTIAL
D STATUS CHECK
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
o PARTIAL
PASSED FAILED
~ 0
COMMENTS:
PASSED FAILED
D D
ELECTRICAL: D ROUGH IN [ZL,PINAL D PERMANENT SERVICE D TEMPORARY SERVICE D PRECONNECT
J
o PARTIAL'
PASSED FAILED
~D
COMMENTS:
MECHANICAL:D ROUGH-IN D AJC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
o D
COMMENTS:
PLUMBING: D GROUNDWORK D ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
o D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR'
~'W+
DATE OF INSPECTION MADE: '7 - [ .t"~, if 'l
!()ll"''''
TIMF' .' , -6
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY