BP13233
Blair Building Permit Detail
Permit #: 13233 Issued:
Completed:
Location: 838 N 15th St
Owner: Preston & Alisha Liekhus
Address: 838 N 15th St
6/9/2009
10/1/2009
Type: Residential Remodeling
Valuation: 49923
Blair, NE 68008
Phone: 402 278 0555
Permit Fee:
Issue Fee:
Deposit Amt.:
Receipt #:
619
25
500
24789
Section:
Subdivision:
Township:
Range:
Lot: 25
Block:
Re-modeling Fire damaged house. Replacing carpet. Re-doing drywall entire basement and 1 wall on main floor.
Roof Repair - 1 wall re-framed. in basement. Adding drain in bathroom in basement.
Contractors
Paul Davis Systems, Inc.
Kocsis Electric, Inc.
Morehead Plumbing
SELF
Remarks
General Contractor Permit # Issued
Electrical Subcontractor E3128 7/20/2009
Plumbing Subcontractor P2029 7/20/2009
Heating Subcontractor M1885 6/24/2009
7/21/2009
HOW
1. framing inspection: Provide egress opening for basement living space as per Section 310.1
8/4/2009
HOW
1.scope: basement egress window -ok-hw-Iadder will be installed later, prior to final.
8/4/2009
HOW
1. scope: basement waterproofing-final-ok-hw.
8/7/2009 HOW 1. insulation-ext wall-ok-hw.
Inspections Date By
7/21/2007 HOW Electrical Rough-ins Pass
7/21/2009 HOW Framing Fail
7/21/2009 HOW Plumbing Rough-ins Pass
7/21/2009 HOW Mechanical Rough-ins Pass
8/4/2009 HOW Final Inspection of Project Pass Partial
8/4/2009 HOW Egress Windows Pass
8/7/2009 HOW Framing Pass
9/11/2009 KAR Electrical Permanent Service Pass
9/24/2009 HOW Plumbing Final Pass
9/24/2009 HOW Mechanical Final Pass
9/24/2009 HOW Final Inspection of Project Pass Partial
10/1/2009 KAR Final Inspection of Project Pass
E ~J
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ciH'D
CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit# /8:<83
Date: (jJ"" q....O Cf
Site Plan Attached:
REScheck Attached:
Approximate Completion Date: ...-1'" 1- ;;l () 10
Complete Plans Attached ~
Application for: Residential .....::i:...... 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: BIClir _ Kennard_
County Road Permit Required: Yes_ No _ Submitted: Yes No
Additional Description of project if necessary': ~J ;:nt1 delvn . ~4.I ~mv a
'. ' ,', I. . 6 '- IJ-h-, , r. " ~f-
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4c1ct?nq.. d1cP;~ ~ h.a ;At7d'Jn ~ h ~ 6~ &.
Proiect Infor!'m{tion:
Job Address:
8:3/3 Ii /s#\- JJL. 8Cj'005gL/78
Legal Description (if applicable) J3(! cS'ftJ~ .4J),D .d;;{1- dJ5 lief' }De/
owner:f?A.Mlcm /;1~//()v ;;I~.e~ss: &3& ;<I, /5'# Sf-, Phone#: :? 78 ,tJG"55
Contractor: ~J ~tltl.i4 &k'1a-tip~/rr5~ Phone#: 653-0373
n I
0D()6 u', u/ sr~.I/tI.I. {!M
Cell #:
Address:
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 ~r Is not completed within two (2) years of date of issue.
all~dl/
ignature of Owner/Contractor
6).to
ZONING REVIEW:
Zonim!/Flood Plain/Utilities:
Current Zoning: ~ rn Conditional Use Permit Required: Yes _ No"'/
\ , Date c~pproved: -r--
State Fire Marshal Required: Yes _ No . Variance Required: Yes _ No
Minimum Setbacks: Front..a1L Second Fr~~ Side 7 Side --=;L Rear
Lot Sauare Foota~e:
Length x Width: Lot Coverage %::ID'f\ /'"
Drivewavs/Sidewalks: f ~ 11
Sidewalk required: Yes No _ Sidewalk Waive: Yes _ No
Date Waiver Approved:
Preexisting Garage requi es driveway to be less than 3' from property line: Yes_
Approved by:
Flood Plain: Yes No ~
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
Number of Stories
One -fL- 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: r, to K
Side
Front Side
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, supervised environment _
Institutional, incapacitated _ Institutional, restrained _
Institutional, day care facilities _ Mercantile _ Residential, hotels_
Residential, multiple family _ Residential, one- and two-family -X-
Residential, care/assisted living facilities
Storage, moderate hazard _ Storage, low hazard _ Utility, miscellaneous _
Is bu~ldinJ:! required to be protected bv automatic fire sprinkler system?"
No X
Onlyrp;.tially 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 _ AJ(~1-
(Dale will review new residential construction. Al will review all second access requests and industrial and
commercial driveway requests)
Required Off Street Parking:
tJ I ft-
Permit Fee Calculation:
BuildinJ:! 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 ndustrial/Educational/ Assembly/Factory/Storage/Utility
*Porches with roofs/screened patios are considered additions
Construction valuation computation: Sqjft area X $63
Except for the following:
Accessory Buildings & Interior Remodeling Projects: sqjft area X $43
Pole barns with no hard surface floor: sqjft area X $25
Sign ErectimVAwnings and Decks/Handicap Ramps: sqjft area X $25 (Minimum
valuation of $2000) . II' hi
Wft ,UI L/1,1 #3
Construction valuation computation: . ... II X $ 1l3. 1-1 t9 ~ =2
Finished sqjft area flo\\ '1 $ ~lJ '1~~)
~
Construction valuation is ...................................Permit fee is:
$0 TO $50.......................................................... $0
$51 TO $500........................................................$25
$501 TO $2,000 ........................................................$25
$2,001 TO $25,000 ........................................................$70
$25,001 TO $50,000..................................................... $370
$50,001 TO $100,000..................................................... $620
$100,001 TO $500,000..................................................... $970
$500,001 TO$1,OOO,OOO ..................................................$2,970
$1,000,001 AND OVER ..................................................$4,970
+ $3
+$13
+$10
+ $7
+ $5
+ $4
+ $3
per additional $100
per additional $1,000
per additional $1,000
per additional $1,000
per additional $1,000
per additional $1,000
per additional $1,000
$ (Olq.OO
$ 25.00 -:::{; t.fLf _ 00
$ I J I 4- 4-. 00
Permit Fee calculated from chart above
Issuance Fee:
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
Additional Comments:
Approved by: "j)l1~ Q\Qt~
.
Date:
&!J-Ior
. t
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
5"tc< iY d'i ~(+ ,10
00+ ') ,ei c:-.
For Office Use Only
Date Permit Paid:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:! - v{ IJ d J1
Job Address
Comments:
Notice
I hereby certifY that I have read and examined this
application and know the same to be true and correct. All
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.
& Cl (t!C? ci/u cl
Signature of Contractor or Authorized Agent
Date
Pennit Fee: $
Zip
No.
Kitchen. .. . .. .. . .. . .. . .. . .. . . .. .. . .. . $12.00 x
Bath.. ...Residential/Single Stall $12.00 x_
.................. ..Multi-Stall $25.00 x
Rough-In Bath.................. ......$8.00 x_
Additional Sinks.... ...... ......... ..$6.00 x
. )v..Y:b t~ IJ ~f)e.
Slop SlllkJ~aundry Trtyi'Oram.....$6.00 x
~rWoorer:.. ~'.i-;'>.. .l.~ .I!-.~ ....$1 0.00 x
Outside Water Faucet...................$6.00 x
Drinking Fountain........................$6.00 x_
Backflow/Grease Trap............. $15.00
Water Service...................... .$15.00
Sewer.............................. ...$15.00
Groundwork... ... ... ... ... ..........$15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System.. . ....... ..$1 0.00
Sprinkler System (Commercial)..$30.00
Gas/Water Piping System
(Commercial)..................... ...$50.00
Pennit Issuance Fee... ... ... ....... .$25.00
Current License on File
Comment:
Total
o NjA
es 0 No
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: c!!S f?-;/~
(3;;138
P 2029
Phone
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Rev. 2008-10
Aug, 3. 2009 2: 03PM
CITY OF BLAIR (402,426,4191)
No, 1800 p, 1/1
PLUMBIN'G PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16tb Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date:
Job Address
Comments~
Notice
I hereby certify that I have read and examined this
appliClltion and know the same to be true and correct All
provisions of laws and ordinances governing this type of
work will be compiled with whether specified herein 01'
not The granting of a permit does not Pl'esume to give
authority to violate Or cancellhe provisions of any other
state Or local law regulating construction or tho
performance of construction.
bate
Permit Fee: $
fJ., IS~'
['f
Zip
l.o f Yr>
P 2029
CG:,Jo
Phone
o Replacement
No.
Kitchell... ... ...................... ..$12.00 x
Bath... ..Residential/Single Stall $12.00 x _
....................MuIti-Stall $25.00 x
Rough-In Bath.... .............. ......$8.00 x_
Additional Sinks................... ..$6.00 x
Slop SinkIHtit'n'fJtriy}8fain.....$6.00 x =
~.~k5~oat6r...~v.$...l.LlJ...~....$10.00 x
Outside Water Faucet...................$6.00 x
Drinking Fountain........................$6.00 x_
Backflow/Grease Trap........... ..$15.00
Water Service... .................. ..$15.00
Sewer.....".................... ......$15.00
Groundwork............... ......' ...$15.00
Septic Tank & Laterals....... ..... $15.00
LaWn Sprinkler System..... .......$10.00
Sprinkler System (Commercial)..$30.00
Gas/Water Piping System
(Commercial)...,........... ...... ...$50.00
Permit Issuance Fee.............. ...$25.00
CUlrent License on File
Comment:
Total
es 0 No 0 NjA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
~rOVedBY: C5 ;:0/~
I).OV
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Rev. 2008-10
2 4
ELECTRICAL PERMIT APPLICATION ~3
Jurisdiction of City of Blair, Nebraska ~ '3 J '-'
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
~
Application Date:
"7 -) 0 "Ul
Job Address
'"
I
Permit Fee: $
E 3128
~Sd~
Ownil'i\ -+
1.'V J\.l(;2~
COIlf;Jctor , ."
2. K.c) C~ I
3. Class of Work:
Describe Work" .-'
4. (D
5.Current License on File
~3? jJ j IS
-t A l,~~dd~~~
r/' + Mail Address .."'"'7 1 '- S'''' ~'~I 7l-. If- l\ A.~ Zjp I ~J -.. Phone'77) (;.(;.u
c- t"'r: rtJ c... :5 IJJL> ...;:. w l-1 UfY~t"_ ltIl) i I :> }-(J @ T,
o NEW RESIDENTIAL 0 NEW COMMERCIAL 0 REMODELING/ADDITIONS 0 UPGRADE SERVICE
/S-O~ ~
'Yes 0 No 0 N/A
Service Fee = (Amp Fee + $5.00 per branch circuit)
1-100 Amp Fee......... ..............$25.00
10 1-200 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 1 00 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.
Signature of Contractor or Authorized Agent
Date
Zip
Phone
<\,
/1.J2flru<-e4
3 - 1 ~ 10
ELECTRICAL PERMIT FEES
;<5" CJ.2--
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
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)
Receptac1es/Switches/Lig~tin~ Fi~ures (110 volt .?nl~
# of Apparatus .......... '? S . w x $1. 00 3> S; .....J
Power Apparatus (220 Volt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.....
x $3.00
'\~r-.. (J~
Permit Issuance Fee......... ......... .$25.00 of
Total ?,
q,;l.
Comment:
WHEN PRO PERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: ~i3, PJ I- ~
I
Rev. 2008-10
~
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
~j? jJ" I~
~~vn~ ~ -t A ~dd~ Zip Phone
~~t~rCS:~ Sled~f~ddress 57J~ s. S-t,Jh U-()~ ft,fJ I,Phone7"53_ff'l
3. Class of Work: 0 NEW RESIDENTIAL 0 NEW COMMERCIAL 0 REMODELING/ADDITIONS 0 UPGRADE SERVICE
Describe Work ), V- -a-tl .r A () ,
4. I D :.) ~'? l1:/l-M ~
5.CurrentLicenseonFile ,Yes 0 No 0 N/A '-1- 16
ELECTRICAL PERMIT FEES
)~ o.E..
Application Date:
7 -) 0 .'J~
Job Address
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 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.
0-2(-
Date
Permit Fee: $
E 3128
~\O
~~v_
Upgrade Existing Service........... ..$25.00
Temporary 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 onl~
# of Apparatus .......... 15.W x$1.00 35; ..uJ
Power Apparatus (220 Volt 01' higher)
# of Apparatus....... x $8.00
Smoke Detectors.....
x $3.00
') (' 09--
Permit Issuance Fee.................. .$25.00 d":>
Total ?
d..$l
Comment:
WHEN PROPERL Y VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: is. PJ I- ~
I
Rev. 2008-10
\ .3 :;10 '?
MECHANICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
~
Application Date:
&~} Lj-()
Job Address
Permit Fee: $
M 1885
Lf ().. ()
'If-.
Zip
Zip
o COMMERCIAL 'RESIDENTIAL
'-fJ/J d r!J1 C:UU 'e cJJ
o Addition 0 Alteration )Sl Repair
'7) I ;/
'#'1c,alj
MECHANICAL PERMIT FEES
Heat Pump
Central A/C
r7
~
Tons
Tons
Furnace
BTUIH
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.
{J 9
Date
Furnac%fIeatp'~;P~r Conditioner (Per Unit) t,tJ
Up to ~Gl.oomg-{OO,OOO BTU / 3Ton................. ....... ....$15.00
FurnaceIHeat 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
. t) f-1
Permit Issuance Fee... ... ... ... ... ........... $25.00
Total
Current License on File ~es 0 No 0 NjA
ilL)
Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: (1) ;::, (. .
~15 . J r~~t------
Rev. 2008-10
CITY or 5LNQ
HOMEOWNER VERIFICATION FOR PLUMBING AND/OR
MECHANICAL PERMITS
P 115h(~ L J ej< h U~
Prmt your full name on line above:
, states the following:
1.
I am the owner of the single family dwelling for which I am applying for a
plumbing and/or mechanical permit.
. C:'~'- 0 L
I:) 0'-,
Address:
o?)?) N
b\ G_\'r \ N ~ ualn~
\
2.
I am applying for a plumbing and/or mechanical permit for a single family
dwelling and it is or will be my principal residence.
3.
I will install and connect the plumbing and/or mechanical by myself, without
compensation or pay from or to, any other person.
4.
I have sufficient knowledge of the 2006 International Code requirements to make
an electrically safe and mechanically secure installation, which will meet the
minimum standards referenced in the 2006 International Code.
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 plumbing and/or
mechanical.
7.
I am aware that violation of the code 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.
J2-K~ ~ 'dV-();
ate
(i)-
EQUJ.LHOUSING
OPPORTUNITY
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cityofblair@cLblair.ne.us
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
ADDRESS
CITY: STATE, ZIP CODE
"_/" ,
THANK YOU
KEEP THIS COPY FOR YOUR RECORDS.
.I j
NO
....,-",..,
RECEIVED BY
Pounds Printing, Blair, NE 68006
CITY or BLNQ
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 ;r{~
Owner/Occupant Contractor
City of Blair
~ ~ / f 't !Q ~
ate
(5)-
218 South 16th Street. Blair, Nebraska 68008 . 402-426-4191 . Fax 402-426-4195 . E-mail cilyofblair@cLblair,ne, us ~W,'o':~~::~1
~
~
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~
'..<l 0'
Promi",e
BUILDING PERMIT DEPOSIT AGREEMENT
/.~..-.....~.~,
~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.
(), ,
ontractor/Owner
Contractor/Owner
City of Blair
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Brandy Petersen
From:
Sent:
To:
Subject:
Attachments:
Aaron Steube [asteube@pdromaha.com]
Tuesday, June 09, 2009 9:42 AM
Brandy Petersen
Uekhus permit for fire restoration
Uekhus - Sketch,pdf
Brandy,
Here is the floor plans that I have for the job.
The homeowners are:
Preston & Alisha Liekhus
838 N 15th Street
Blair, NE 68008
(402) 278-0555
All of that information is also on the top of the first page of the sketch.
If you need any more information please call me on my mobile number.
Thanks,
Aaron Steube
Estimator
3505 South 61st Ave. Cr.
Omaha, NE 68106
Mobile: (402) 208-8379
Office: (402) 553-0373 Ext.142
Fax: (402) 553-0334
f?PAUL DAVIS
RESTORATION
"We Restore Lives"
1
BUILDING INSPECTION REPORT
CITY OF BLAIR
o WASHINGTON COUNTY
LOCATION OF INSPECTION'
.. -..')
l j ,.f. /
NAME OF OWNER' ./,:~tt() /ey;n
DATE INSPECTION REQUESTED.-:;~~{-~~1~ it1lf/l
/:.~ ~
-., )
TYPE OF INSPECTION REQUESTED:
BUILDING: 0 FOOTING 0 DECK FOOTING
l I
/',; .
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o OTHER
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CONTRACTOR'
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TIME INSPECTION REQUESTED'
-~-){): ). /1' i.. PERMIT
o CONFERENCE
o 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:
PASSED FAILED
o 0
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE.l3J:YEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
~ED
COMMENTS:
MECHANICAL:D ROUGH-IN 0 NC 0 FURNACE D RADIANT HEAT 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:
o OCCUPANCY GRANTED
NOTES/REMARKS'
o CONDITIONAL OCCUPANCY GRANTED
~f'^~ G'c ()c)(3>' heaei 'S'eNtC-e
~OPPD\BURT REA A
L/ jlJW{~JJ u
,
INSPECTOR.~(;i.Q fJ1~
to OVr \0
DATE OF INSPECTION MADE: ey; - J / .~c::r7 TIME' '3 -~ C3e!f
,
TO CONNECT SERVICE: ON
BY
~~
ELECTRICAL PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 E 3106
(402) 426-4191
Application Date:
ij, 6t-oq
Job Address
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 additional100 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.
~ A IJ-OC
Date
~ooo
Permit Fee: $ ,/
Zip
Phone
E/88~ ;?& 0
-{ Zip Phone. C,
5 Son s+ Ol'V\ CL k"",- AJ Z- <..0 ~ III "13'3" 8~"\..f 0
REMODELING/ADDITIONS,,; UPGRADE SERVICE
. u.., to n VQ.,. l\&VV1 C
Completion Date
ELECTRICAL PERMIT FEES
Upgrad~_Exis..t!Qg Service...,........ .$25.00
~r~51.od:ee.................." $15.00
~~Alarm System................., ...$15.00
Signs (each)........................ ......$25.00
Miscellaneous Apparatus. . . . . . . . . .... .$15.00
/ S .On
Commercial/Multi 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/Lighting Fixtures (110 volt only)
# of Apparatus.......... x $1.00
Power Apparatus (220 V oIt or higher)
# of Apparatus....... x $8.00
Smoke Detectors.....
x $3.00
Permit Issuance Fee......... ........ ..$25.00
oIS.Qj
L(Oi9
Total
Comment:
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: ~ li5\j cl VlL.VC-
Rev. 2008-10
1:JfJ.
o CITY OF BLAIR
BUILDING INSPECTION REPORT
o WASHINGTON COUNTY
o OTHER
i) ~ \f ~'1" A \:;\., ~ ' ."(1':';'''. A~
CONTRACTOR- i ,j, \j,,' r' I T p} 1",j'{I/'iVt\l)
~'\' ,',
TIME INSPECTION REQUESTED- j : '; ~? PERMIT NO' " ,
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE 0 STATUS CHECK
BUILDING, D FomlNG D DECK FOOTING )r"FRAMING ~ DRYWAlL D FINAL D PARTIAL ;;; ~
~~~.~~-=,_.____~LJ.~~",{$_~~~~~~z~~~kl:,S-=_~&-=-=~_~~_
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC D WATER TAP D REMOTE D WATER SERVICE PASSED FAILED
D PARTIAL D D
t; 'i
{'~ ,I'''''''. <_,_",[ (",:\,;{~~L:-:"
LOCATION OF INSPECTION-
NAME OF OWNER'
{') l) ~::: -- .'!/' j~? ~-? 1
DATE INSPECTION REQUESTED-
~
l
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COMMENTS:
~? F~ED
COMMENTS:
PLUMBING: D GROUNDWORK"5.]/ROUGH-IN D FINAL D WATER METER INSTALLED 0 PARTIAL
D PRESSURE TES~'"
FAILED
D
COMMENTS:
~SED FAILED
~'D
D OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS- c1) F (LI.l...IA/o. I/~ ~pV ~~ ~ 1lJ :,,-~ - r'ev<J ~ ~ tIc1 c. s s... T (..I..;. L C-
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INSPECTOR-
~'7V/.~
DATE OF INSPECTION MADE: "7-- J- ( , 0 1 TIMF-
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
RcrrYOFBLAffi D =~~~:O: INSP~~:~N REPO\~5~
LOCATION OF INSPECTION' /- ~ ~.;( > ,/lj,,/ ,J) ! / ,/, _ J"):3 -65 J ~
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NAME OF OWNER' /'-::,,:i{~' ,./'/1 ," :." ,. '.." (:0., CONTRACTOR',' :,}? iJ c, '..frS'"
DATE INSPECTION REQUESTED' I
r7 ..,,) f j
<,;'~~<-(!_:':5;' ..,. ~ f.;J'
,1
TIME INSPECTION REQUESTED' " i~l "
PERMIT
TYPE OF INSPECTION
D CONFERENCE
D STATUS CHECK
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
PASSED FAILED
D D
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATERTAP D REMOTE D WATER SERVICE
D PARTIAL
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 NC 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:
D OCCUPANCY GRANTED D CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS' 'i/~ic':' j' //(?
INSPECTOR'
DATE OF INSPECTION MADE:
TIMF'
FAXED OPPD\BURTREA
TO CONNECT SERVICE: ON
BY
~,
CITY OF BLAIR
BUILDING INSPECTION REI
o WASHINGTON COUNTY
o OTHER
,I
LOCATION OF INSPECTION'
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j." ,",I .,"', t
DATE INSPECTION REQUESTED' i 5:/ ,.' II .i,i /
/ if
TIME INSPECTION REQUESTED' . Ii, ,
TYPE OF INSPECTION REQUESTED: , 0 (
~,"""'~='=wz
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYW!{ ,';~r F AL [
_S2~!i~:~,~=~~~!lz~&~6L~~~~~~~' C1Iil:i~~
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 V
o PARTIAL
COMMENTS:
ELECTRICAL: 0 ROUGH IN
o PARTIAL
o PERMANENT SERVICE 0 TEMPORARY SERVICE [
COMMENTS:
MECHANICAL: 0 ROUGH-IN 0 AlC 0 FURNACE 0 RADIANT
o Pi
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN
o PRESSURE TEST
FINAL 0 WATER METER INSTALLED
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
).Jo --foe ~ W",L-L L Ai'$-+c:.Lt...
t-1:utJ... we. ..
INSPECTOR'
~~~
DATE OF INSPECTION MADE:~
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
~.
BUILDING INSPECTION REPORT
CITY OF BLAIR
/,j")~:=,:,)'"
\...",9"- f
TIME INSPECTION REQUESTED' ,/
o
LOCATION OF
NAME OF
DATE INSPECTION REQUESTED' ,,=Y ,;)
TYPE OF INSPECTION REQUESTED: 0 CONFERENCE
BUILDING: 0 FOOTING 0 DECK FOOTING 0 FRAMING 0 DRYWALL 0 FINAL 0 PARTIAL
COMMENTS: t:k-t. (JVCJ!.- (...l- ~ L;)'ew..~
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC 0 WATER TAP 0 REMOTE 0 WATERSERVICE
o PARTIAL
o STATUS CHECK
PASSED FAILED
~ 0
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
MECHANICAL:O 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:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS'
INSPECTOR' "?I1/fI~~
FAXED OPPD\BURT REA
DATE OF INSPECTION MADE: ~- ~ - 0 '{
~
J.~t ve.J2
TIMF' J J.. b tfr
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
CITY OF BLAIR
D WASHINGTON COUNTY
LOCATION OF INSPECTION'
NAME OF OWNER' C! it" tel, i '>
'i' ~:J :y'
t'J" , f \
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DATE INSPECTION REQUESTED' ,
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TIME INSPECTION REQUESTED' l..i " (J():: \ y'VI, PERMIT NO'
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TYPE OF INSPECTION
D CONFERENCE
D STATUS CHECK
BUILDING: D FOOTING D DECK FOOTING D FRAMING D DRYWALL D FINAL D PARTIAL
COMMENTS:
UTILITIES: D SEWER TAP D SEWER D SEPTIC D WATER TAP D REMOTE D WATER SERVICE
D PARTIAL
PASSED FAILED
D D
PASSED FAILED
D D
COMMENTS:
ELECTRICAL: D ROUGH IN D
D PARTIAL
SERVICE D TEMPORARY SERVICE D PRECONNECT
~ED
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 WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
D D
COMMENTS:
D OCCUPANCY GRANTED D CONDI~}NAL OCCUPANCY GRANTED
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DATEOFINSPECTIONMADE61'-ly-~ TI4/,r
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
[Zl CITY OF BLAIR
o WASHINGTON COUNTY
o OTHER
LOCATION OF INSPECTION'
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TIME INSPECTION REQUESTED- \ (~) . \:)0
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DATE INSPECTION REQUESTED-
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PERMIT NO- L..,)
COMMENTS:
UTILITIES: 0
o
o CONFERENCE
FINAL ~ARTIAL
o STATUS CHECK
TYPE OF INSPECTION REQUESTED:
BUILDING: 0 FOOTING 0 DECK FOOTING
FAILED
o
o WATER TAP 0 REMOTE 0 WATER SERVICE
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH IN 0 FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
MECHANICAL:O ROUGH-IN 0 A/C 0 FURNACE 0 RADIANTHEAT ,P/PINAL 0 PARTIAL
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN [}"FINAL 0 WATERMETERINSTALLED 0 PARTIAL
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o PRESSURE TEST
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~ 0
COMMENTS:
o OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
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NOTES/REMARKS-
INSPECTOR'
j(;7-?vpy-
DATE OF INSPECTION MADE:
9' -J'f--O ~ TIME- /0 !(J(/tyjWL
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
1'3,:,CITY OF BLAIR 0
LOCATION OF
NAME OF
DATE INSPECTION REQUESTED'
;'
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TIME INSPECTION REQUESTED' " t... (< c//f, l'rpERMITNO-
TYPE OF INSPECTION REQUESTED: 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 WATERTAP 0 REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o 0
COMMENTS:
ELECTRICAL: 0 ROUGH
o PARTIAL
PASSED FAILED
o 0
FINAL 0 PERMANENT SERVICE 0 TEMPORARY SERVICE 0 PRECONNECT
PASSED E4J..LED...,.....-
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COMMENTS:
MECHANICAL: 0 ROUGH-IN 0 A/C 0 FURNACE 0 RADIANT HEAT 0
OJ 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 D CONDffiONAL OCCUPANCY "rED . / .. /:' lJ . I
NOTES/REMARKS- J;;~-f ~ oVP.;""'" ~ ~O~~~~C'y JI-t
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INSPECTO -
DATE OF INSPECTION MADE:
CJ9-;<Y09TIMR' ){).::2Q
, F
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY
BUILDING INSPECTION REPORT
OF BLAIR
D WASHINGTON COUNTY
D OTHER
LOCATION OF INSPECTION'
, (~:/j ;'.{I :(f
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DATE INSPECTION REQUESTED- ,
TIME INSPECTION REQUESTED- /.
/') ""'J
.)1/ ! ,/ II i' PERMIT
TYPE OF INSPECTION REQUESTED:
BUILDING: 0 FOOTING D DECK FOOTING 0 FRAMING 0 DRYWALL
o CONFERENCE
:FINAL D PARTIAL
o STATUS CHECK
PASSED FAILED
D D
COMMENTS:
UTILITIES: 0 SEWER TAP 0 SEWER 0 SEPTIC D WATER TAP D REMOTE 0 WATER SERVICE
o PARTIAL
PASSED FAILED
o D
COMMENTS:
ELECTRICAL: 0 ROUGHrN:E:LFINAL 0 PERMANENT SERVICE D TEMPORARY SERVICE 0 PRECONNECT
o PARTIAL
COMMENTS:
MECHANICAL:D ROUGH-IN D AlC D FURNACE D RADIANT HEAT D FINAL 0 PARTIAL
PASSED FAILED
D 0
COMMENTS:
PLUMBING: 0 GROUNDWORK 0 ROUGH-IN D FINAL D WATERMETERINSTALLED D PARTIAL
D PRESSURE TEST
PASSED FAILED
o 0
COMMENTS:
D OCCUPANCY GRANTED 0 CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS-
mSPELWR K~a I~
DATEOFINSPECTIONMADE:/O -d I ~ctfrTIMF-) : ~
FAXED OPPD\BURT REA
TO CONNECT SERVICE: ON
BY