BP13150
Blair Building Permit Detail
Permit #: 13150 Issued:
Completed:
Location: 1523 Washington St
Owner: Washington County Bank
Address: 1523 Washington St
3/1/2009
5/28/2009
Type: Industrial/Commercial - Remodeling
Valuation: 9288
Blair, NE 68008
Phone: 426-2111
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
161
25
200
24209
Section:
Subdivision:
Township:
Range:
Lot: 1 to 11
Block: 47
12x18 office addition by adding one 18' wall. The wall will be glass with wood framing. Will have new lighting above
open area outside office.
Contractors
Bart Moore Subcontracting, Inc.
Dick's Electric
General Contractor
Electrical Subcontractor
Permit #
E3086
Issued
3/16/2009
Remarks
3/25/2009
DEM
Smoke Barriers Required.
3/25/2009 DEM Looked at Framing, but not ready.
Inspections Date By
3/25/2009 DEM Framing Fail
5/28/2009 KAR Final Inspection of Project Pass
5/28/2009 JAMIE Electrical Final Pass
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1
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # J 31 (5()
Date:
,~' .i
q
Approximate Completion Date: .~5"~ .,3 J ~ DC?
i. '>( -
Site Plan Attached: 'A
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:
I
iJ.~I() hick 77 ?" '(,.'if'J \.) If.
(
Legal Description (if applicable)!'~{! .';/0 lS
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Owner: tUZ:i f;c.tl1L;/vr1 Lt)(,iA1/-ff Address:
~"J (I () " '
contract~ft?lt :?l/c'J?r1J (7'01'7 itA cJeiHcv
Address: fiLI/;J.;;l t/ 111 ,4" '-f ~
/ -/1 .~:;1,;?~3{j i~lit, if] //'-1 /l!., I
Phone#: 1fJ7? t. '-d? /! I
Phone #:
Cell #: 533 -:':':5175-[:)
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
1~~ayS or i completed within two (2) years of date of issue.
,ll1.fi
Signature of Owner/Contractor Date
ZONING REVIEW:
Zonin Flood Plain
Current Zoning: Conditional Use Permit Required: Yes _ No L
Date CUP Approved:
State Fire Marshal Required: Yes _ No _ Variance Required: Yes _ No_
Minimum Setbacks: Front _ serJd :Wnt Side Side Rear_
Lot Sauare Foota~e: ! It II I 1:1-
Length x Width: Lot Coverage %~
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:
Building 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:
Business/I nd ustrial/Ed ucationa 1/ Assem bly/Factory /Storage/Utility
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sq/ft area X $63
Except for the following:
Accessory Buildings & Interior Remodeling Proiects: sq/ft area X $43
Pole barns with no hard surface floor: sq/ft area X $25
Sign Erectin~ Awnings and Decks/Handicap Ramps: sq/ft area X $25 (Minimum
valuation of $2000)
Construction valuation computation:
Finished sq/ft area - d--I ~
X$ 1.4,'3
$
,'7 >1 ~)
~ 0:;.... {"..C to
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
$ ;! {' l ",.:>
i l", _ '
Issuance Fee:
$
$
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25.00 -:: I 8
D(j
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
Additional Comments:
APprOVecF9\c: / ~ ~ Date:
Contingent On Approval by Fire Marshall ><-
Meet IBC, IPC, IMC and NEC Code Requirements J<.
Sleeping Rooms below Story and in Basement required to have egress
i /
Jss/u9
, 6'
For Office Use Only
Date Permit Paid:
Permit Fee: I fB Ii? th'
Deposit Amount .:;J tJ () ,/?t'
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
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ELECTRICAL PERMIT APPLICAtlON
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:
Job Address
1.
c
2. \
3. Class of Work: 0
Describe Work:
4.
5.Current License onFile 0 Yes 0 No 0 N/A
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
15t 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. AIl
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.
\
E 3086
Permit Fee: $
Zip
Zip
REMODELING/ADDITIONS 0 UPGRADE SERVICE
Completion Date
ELECTRICAL PERMIT FEES
Upgrade Existing Service............ .$25.00
T emporaty Service...... .. .. .. .. .. .... $15.00
Fire Alarm System................. ....$15.00
Signs (each)......................... .....$25.00
Miscellaneous Apparatus......... .....$15.00
CommerciallMulti Family and All Upgrades:
# of Circuits x $5.00
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/Lightin~ Fixtures (110 volt only)
# fA - I $1 00 "''''~l r\1~
o pparatus .......... ' x. ex I ,",",J
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.....
x $3.00
Permit Issuance Fee................. ..$25.00
Total
Comment:
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: \/i'i\J&\\i\17 ii '.
, '~,., t"-~,.,,.f'\._l'.J t:~ ',J "',., ~
Rev. 2008-10
CITY OF LAIR, 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
&zJ-fj-t~ Stib J;K.
Contractor/Owner
City of Blair
3--9 -tJ9
Date
CITY or 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.
Owner/Occupant
&J1JMQ. ~i~..
Contractor
3'.9-{)9
Date
City of Blair
(5)-
218 South 16th street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblalr@ci.blair.ne.us ::~'':-:fJ:~:
-:;;;Ii;? BUILDING INSPECTION REPORT
~~y OF BLAIR D WASHINGTON COUNTY D OTHER
LOCATION OF INSPECTION' /5--2.:3 /LJ /l.~/I///C;7/3/1
N~~R/~a:.tU/4I SA/I,) K CONTRACTOR'
DATEINSPECTIONREQUEST~,_.:s;hs- TIME INSPECTION REQUESTED' / -' {)6 PERMIT NO' /C. 1; q-O
TYPE OF INSPECTION REQUESTED: ~ONFERENCE . D STATUS CHECK
~UILDING: D FOOTING D DECK FOOTING [Z( FRAMING D 'DRYWALL D Fr:AL D PARTIAL PASSED FAILED
, LO~rf A7 t~y J!6}~i D D
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
CO:rvIMENTS:
PASSED FAILED
D D
CO:rvIMENTS:
ELECTRICAL: D ROUGH IN D FINAL D PERMANENT SERVICE D Tt:MP,qRAl~Y SERVICE D PRECONNECT
D PARTIAL 1:,':"\
\/ \
PASSED FAILED
D D
CO:rvIMENTS:
~~/
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
CO:rvIMENTS:
PLUMBING:
D GROUNDWORK D ROUGH-IN D FINAL D WATER METER INSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTESIREMARKS' bJ / h Lk!- Jf/j ;1/~ II A L
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DATE OF INSPECTION MADE:
~
01 TIMR' IL~J
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
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BUILDING INSPECTION REPORT
OF BLAIR
o WASHINGTON COUNTY
LOCATION OF
TIME INSPECTION REQUESTED.
NAME OF
DATE INSPECTION
E:<;~if :/"
TYPE OF INSPECTION REQUESTED: l! 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH
o PARTIAL
PASSED FAILED
o 0
o PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
~D F~ED
t,
COMMENTS:
MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
PASSED FAILED
o 0
NOTES/REMARKS.
INSPECrOR~~~
FAXEDOPP \BURTREA
DATE OF INSPECTION MADE:,3:P wr
TIME. ////2.$1
TO CONNECT SERVICE: ON BY
BUILDING INSPECTION REPORT
OF BLAIR
o WASHINGTON COUNTY
LOCATION OF
NAME OF
DATE INSPECTION
TIME INSPECTION REQUESTED'
-.-'t, i-'l.r.
"~f . l' ff 'I '.
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL/~:"FINAL 0 PARTIAL
o STATUS CHECK
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
COMMENTS:
MECHANICAL: 0 ROUGH-IN
PASSED FAILED
o 0
FURNACE 0 RADIANT HEAT 0 FINAL 0 PARTIAL
PASSED . FAILED
o 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL n WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
o OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
,"SPECTOR.~~.Ji:~
DATE OF INSPECTION MADE: t)5" Olr- eJ.(){)Cj TIME' J ~ AS"
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY