BP13340Blair Building Permit Detail
Permit #: 13340 Issued: 11/1/2009 Type: Signs
Completed: 3/31/2010 Valuation: 1134
Location: 753 Washington St Blair Plaza
Owner: Midwest Chiropractic Permit Fee: 25
Address: 753 Washington St Blair Plaza Issue Fee: 25
Deposit Amt.: 50
Blair, NE 68008 Receipt #: 25613
Phone:
Section: Township: Range:
Subdivision: Lot: Block:
Store front sign illuminated - electrical permit separate
Contractors
CBS Signs General Contractor Permit # Issued
Remarks
4/9/2010 BMP Jamie ok'd for Howard to final.
Inspections Date By
3/31/2010 HOW Final Inspection of Project Pass
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CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # '':J ~ Lf 0
I~-
Date: i I - I - 0 Cj Approximate Completion Date: I t - 3 0 ~ {) 9
Complete Plans Attached 1../
REScheck Attached:
Site Plan 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 ----iL 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 _
Adcf.itional QescriPtion. 9f prOj~~~if.neces.,sary,:. ,C\i/tYlJ! j~,r7l i-
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Proiect Information:
57 I? '
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Job Address:
Legal Description (if applicable)
Owner: Jvltdwt.<;+ ('J\{fOcYar-/-tc Address: \
Contractor: ~\3:,S 5 i ~ (\ ((}j.
Address: 2- 19zo {J(aIleV({L-0 I~ C'r{{e'/-fJCi 0!(JZ6
Phone#:
Phone #: 4-02 -33L
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
Inspe r. I hereby agree to perform the proposed work in accordance with the specifications set forth above and in accordance with the
9 es/or nances of the City of Blair and the ate of Nebraska. I understand that this permit is void if work is not commenced within
/'180 days r' co plete within t ( e~ \; of date of issue.
"-~
Date
For Building Permits other than One & Two Family Residential Structures:
I hereby acknowledge and agree that I have/will submit a set of plans for this project to the Nebraska State Fire Marshal's Office for
Review.
Signature of Owner/Contractor
Date
ZONING REVIEW:
Zonin Flood Plain Utilities: l"
Current Zoning: c.J~t Conditional Use Permit Required: Yes _ No LS:..-
Date ~:pproved:
State Fire Marshal Required: Yes _ N9- Variance Required: Yes _ No_
Minimum Setbacks: Front _ Second Front:-r:- Side Side _ Rear_
lot Square Foota~e: I\JJ \-- Jfy-
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
Square Footage:
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 building 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:
Businessjl nd ustria I/Ed ucationa 1/ Assem blyjF actoryjStoragejUtility
*Porches with roofs/screened patios are considered additions
'70
\~Iu~2 '
\ DvLJ
Construction valuation computation: Sqjft area X $63
Except for the following:
Accessory Buildings & Interior Remodeling Proiects: sqjft area X $43
Pole barns with no hard surface floor: sqjft area X $25
Sign Erecting/Awnin~s and Decks/Handicap Ramps: sqjft area X $25 (Minimum
valuation of $2000)
Construction valuation computation:
Finished sqjft area '+;::;~ 3 (,
X $ 25-
$ II 34 . 00
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
Issuance Fee:
$ .;{ <::;-~oO
$ 25.00
.50.00
$ IOO.()O
Permit Fee calculated from chart above
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
Additional Comments:
Approved by:
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Date:
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Contingent On Approval by Fire Marshall
Meet (BC, IPC, (MC 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
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CITY OF BLAIR
•
11 u D ram m I a 0 ai
❑ WASHINGTON COUNTY
LOCATION OF
NAME OF
❑ OTHE
r
e
DATE INSPECTION REQUESTED ,c- "' TIME INSPECTION REQUESTED PERMIT
TYPE OF INSPECTION REQUESTED:
❑ CONF EREN C E
7 A
❑ STATUS CHECK
BUILDING:
❑
FOOTING ❑ DECK FOOTING ❑
FRAMING ❑ DRYWALL ❑: `FINAL ❑ PARTIAL
PASSED
FAILED
"
❑
COMMENTS:
UTILITIES:
❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL [:1 PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
El
PARTIAL
F]
❑
COMMENTS:
MECHANICAL: F]
ROUGH -IN ❑ A/C ❑ FURNACE
❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING:
❑
GROUNDWORK ❑ ROUGH -IN ❑
FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
El
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
r
INSPECTO _ SY/ J DATE OF INSPECTION MADE: ` 3 � � t c) TIM
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
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