BP13228
Blair Building Permit Detail
Permit #: 13228 Issued:
Completed:
Location: 1013 N 25th Ave
Owner: Alice Madsen (Holding a 50.00 deposit)
Address: 1013 N 25th Ave
6/5/2009
6/18/2009
Type: Decks - All types
Valuation: 3000
Blair, NE 68008
Phone: 426 4256
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
70
25
50
24745
Section:
Subdivision:
Township:
Range:
Lot: 4
Block:
Replacing cement deck with wood deck 15x8 will have footings using same roof. HOLDING A 50.00 DEPOSIT
Contractors
SELF
General Contractor
Permit #
Issued
Remarks
6/4/2009
BMP
Holding a 50.00 deposit until 09/04/2009.
Inspections Date
6/8/2009
6/18/2009
By
PHIL
KAR
Deck Footings
Final Inspection of Project
Pass
Pass
'Ji lid dh f ~ 41 a. 00 dJpYs.J
hJt~ 711t2~
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit# 1.3~.;28
Date: ~ l ~ l 0 ~ Approximate Completion Date: -, ( I I 0 C;
Sile Plan Allached: -*- REScheck Allached: Complele Plans Allached
Application for: Residential X-- Commercialjlndustrial _
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) --A-
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 _
Contractor:
M\~ MCAd~f"\
5eA~
9Q[)o 55Qa:2..-
\ 0\ '3> N. 25+'" ~\L ~Cda''-!J.J1//1?' \/~j;;~1~(!IO
~~..Y\ Lot l..f Wf5ft(\ ~ Jtfp 2M
Phone#: Ll'UP..lfz.'OiP
Address:
,50..1'1\ €..
Proiect Information:
Job Address:
Legal Description (if applicable)
Owner:
Phone #:
Address:
so..N\e...
Cell #:
Separate permits are required for electrical, plumbing, heartlng, 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. ) further agree that
construction covered by this permit application shall not be commenced until) 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 n completed within two (2) years of date of Issue.
Signature of Owner/Contractor
~/r/o?
Date
ZONING REVIEW:
ZonimVFlood Plain/Utilities:
Current Zoning:
Conditional Use Permit Required: Yes _ No_
Date CUP Approved:
Yes No 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 %
Drivewavs/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
Three
Four
>Four
High Rise (>75 ft)_
Tvpe 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 Rear
Deck that affect setbacks: Rear
Second Level: Third Level
(Finished)
2 bay_ 3 bay_ 4 bay_ 5+ bay
Pole Barn:
Remodel:
Side
Front Side
Occupancv 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~ reauired 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:
Busi ness/I nd ustrialjEd ucationalj Assem bly/Factory/Storage/Util ity
*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 ErectimVAwnings and Decks/Handicap Ramps: sqjft area X $25 (Minimum
valuation of $2000)
Construction valuation comoutation:
Finished sqjft area /d) tJ .
X$ ~5
$
CJ(.'
d {)()O .
.
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
7t? 00
Issuance Fee:
$
$
$
25.00 -::; '1,5. ~o
/ '-/S .to
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
Additional Comments:
APprovedb~ ;?~hdc:L- Dale:
Contingent On Approval by ire 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
~.
ell
~
z
m
'"
'"
o
o
'"
~ ~''1--
() - "-'
m
~ ~
o "'- m
~ \ -0
\: '- :i!
(ij
()
o
-0
-<
"
o
JJ
-<
o
C
JJ
JJ
m
()
o
JJ
o
VJ
z
o
"
'.
.....1-......
~.
("
(,
-l
I
:t>
Z
^
-<
o
c
-.;
--(
.,-
~.+
(
-"'1'-
)
__ I
V
-~~~
'-'
(....
-F
\
.-.;;?~
(
c:-
"
~
,5.......
~
c::-
~. cS'
c:
c:
-~J-
()
.~
(IJ
~
.m
..,.... ~
'. '" 8
~, li1
."..
'"
-~
\
?
-'....
I)..
I
,
'~--
r....
l\:,l'
\:'
~,
~.
E5
o
"'-
~,'
'.
JJ
m
()
~~ ~
(IJ m
(IJ 0
~~
r--~
"
\.)j
s...
\'-.
"
('
........ ...,
.'.
-..j
C'.
/ .
v
t,
'"
......
L
'-,
(
\.
:-<..'
~
(,
o
~
o
-oil
6"tD
~~
0_
/}':xJ
~'"
<t>Z
~m
~tD
:xJ
)>
en
~
',;.., . '~\.
"'''';"
~
~
,,0
~
. ~ 0'
Promi",e
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.
Sndable deposit is being colieeled for ali 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.
~~41fq4~<
Contractor/Owner
Contractor/Owner
City of Blair
9; 6~~/d? ('
Date
BUILDING INSPECTION REPORT
'B::CITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
.l~) /'/", e,')/ /tc,,//
j ) ~ / J' ~\~ /',//l"c~)';;~:
NAME OF
CONTRACTOR "'':~~i~'{/~~)
TIME INSPECTION REQUESTED' ./11. Iv!
,(:,,/,C;~?i(~:'?' '~ri",:,.7 ~-:),.<<~~.)
DATE INSPECTION REQUESTED' 1'tII~;l "l) '::1
PERMIT
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING'-!~7;t'DECKFOOTING 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
P 6~:SBD FAILED
tW 0
/ "
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGHIN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
MECHANICAL:D ROUGH-IN 0 AlC 0 FURNACE 0 RADIANTHEAT 0 FINAL 0 PARTIAL
PASSED FAILED
o 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN 0 FINAL 0 WATERMETERINSTALLED 0 PARTIAL
o PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
D OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
INSPECTOR'
.,.If, ....., ",:I,;t,',l""j',',.,I,',i,//' ",I.~. '.' / . ,
'. . . . . . . . \/"\.l'; t"'~",,?/,,/
l If
DATE OF INSPECTION MADE:
/
"/ ./'
{~"I/ ///l~;:
l !
l /'
TIMF.' 71 :"5' i"
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
,E}'CITY OF BLAIR
NAME OF
DATE INSPECTION REQUESTED' l~'1 /e':'~)
D WASHINGTON COUNTY
I /\ / "')
i/' {,J/ (,~<.,)
,
(~ .'
''''>'...$ .
,~p,",;~1t'~yL~~~?
CONTRACTOR'
') j),L t:)::
(';,'1
./
TIME INSPECTION REQUESTED'
/1 '"I'),,/') '_"j. ."
'~l' . (/ t/ ,';~/' ii~f ~
PERMIT
TYPE OF INSPECTION REQUESTED: D CONFERENCE
BUILDING: D FOOTING D DECK FOOTING ~ FRAMING D DRYWALL .;;FINAL D PARTIAL
COMMENTS:
UTILITIES: D SEWERTAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
D PARTIAL
D STATUS CHECK
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:
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 RADIANTHEAT D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
DATE OF INSPECTION MADE: CJ t9 - /J}<:;;({ffJrIMF' //.' ~t;;
INSPECTO '
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY