The URL can be used to link to this page

BP130930 a c a et CITY OF BLAIRm APPLICATION FOR BUILDINGMIT Permit # 13093 a Date; sol Approximate. Completion Date; 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 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 X Submitted: Yes No Add(12. tional Description of project if necessary. C i Cep w 00 � � . a t 0 � � llt- Ytvl Cexner-\+ -komornt�er-l-t Unp_ ter, r AUrV6 (A .601 It'IiM t V;ro-:ti, • ,.: ?Oroject Information: Job Address:'S C-1 0o� C�ii• f Legal Description (if applicable) �` -s AclA 6 n A bj1 o ' Owner: e'�J ! Address: SCSf`(1 Phone : %2J-32.1 12V Contractor: L h' Phone #: Address: 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. 1 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/or nances of the City of Blair and the State of Nebraska. I understand that this permit is void if work is not commenced within 180 Vay or is not completed ithin two (2) years of date of issue. X79 Signa --Of Owherl ontractor Date ZONING REVIEW: Zoning/Flood Plain Utilities: Current Zoning: Conditional Use Permit Required: Yes No Date CUP Approved: State Fire Marshal Required: Yes No Variance Required: Yes No Minimum Setbacks: Front Second Front Side Side Rear Lot Square Footage: Length x Width: Lot Coverage % D r iveways/S i d ewa I ks: Sidewalk required: Yes No Sidewalk Waiver: Yes _ Date Waiver Approved: Flood Plain: Yes No If yes, specify special requirements: One Two Three Four >Four High Rise (>75 ft) Tvae 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: Second Level: Third Level Basement: (Unfinished) (Finished) Garage: 2 bay 3 bay 4 bay 5+ bay Detached Garage: r-1,TqTqv •, Pole Barn: Remodel: Porch: Front Rear Side Deck that affect setbacks: Rear Front Side Occuuancv 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 High Hazard HPM Institutional, supervised environment Institutional, incapacitated Institutional, restrained Institutional, day care facilities Mercantile Residential, hotels High Hazard HPM Institutional, incapacitated Institutional, day care facilities Residential, multiple family Residential, care/assisted living facilities Institutional, supervised environment Institutional, restrained Mercantile Residential, hotels Residential, one- and two-family Storage, moderate hazard Storage, low hazard Utility, miscellaneous 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. Al will review all second access requests and industrial and commercial driveway requests) Nequired Off Street Parking: Building Permit Deposit Fee: Commercial, new homes and residential additions/remodels/accessory buildings valued $10,000 or greater $ Fee - $500.00 5 cx) .-Co Residential additions/remodels/accessory buildings valued under $10,000 $ '122au Fee = $200.00 All other permits Fee = $50.00 $ RESIDENTIAL - NEW CONSTRUCTION: Permit fee is: Finished sq/ft area X $92 (not including finished basement area) Finished basement sq/ft area X $56 Unfinished basement sq/ft area X $29 Garage sq/ft area X$25 Total Valuation: Total Valuation Multiplied by 0.006 = Issuance Fee: R R $ 25.00 Total Permit Fee = Deposit + Permit Fee + Issuance Fee $ RESIDENTIAL - ADDITIONS / REMODELS and COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS: Business/Industrial/Ed ucational/Assembly/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 Projects: sq/ft area X $43 Pole barns with no hard surface floor: sq/ft area X $25 Sign Erecting/Awnings and Decks/Handicap Ramps: sq/ft area X $25 (Minimum valuation of $2000) Construction valuation computation: Finished sq/ft area ` -. 2 X $ ,_ $ 3 , a_' Construction valuation is ...................................Permit fee is: $0 TO$50 .......................................................... $0 $51 TO $500 ........................................................$25 $501 TO $2,000 ........................................................$25 + $3 per additional $1.00 $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$1,000,000 ..................................................$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 $ 2 � 3, ) Issuance Fee: $25.00 Total Permit Fee = Deposit + Permit Fee + Issuance Fee ._ vyMR,r 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: 0 -®1 a O 5 Permit Fee: _ y 00 Deposit Amount 500 Receipt # Z391% 1 Deposit Paid by for return to: A 1 h1. Building Inspection Pouch given: Yes No (--ate ��Gr CITY ' y NEBRASKA Phone 402-426-4191 RECEIVEDOF: ADDRESS CITY, STATE, ZIP CODE THANK YOU KEEPTHIS COPY FOR YOUR RECORDS. NO RECEIVED BY Pounds Priming,-Bleif,NE 68008 77= F�� O'Wse of OWN 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 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. City of Blair ant Contractor W1 Q_ 218 South 16th Street - Blair, Nebraska 68008 - 402-426-4191 - Fax 402-426-4195 - E-mail cityofblalr@cJ,blalrne.us 8560 800Z/0£/6 39V2WJ 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. 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. f; Y r� 6 xactorl ner Contractor/Owner i City of Blair 0'V , [ Date 8560 800Z/0C/6 �IEMJVO d� s 14 a V ►u u n (D m rt (D Q Q h -n w n 0 y� (D N O CL O 0 O n O 4 -U -y 11 h 11 11 30 Ext 3050 V 00 0 cn 0 u m cp °) c o � 0 J CSi C3� 3050 11-5-8 11-5-8 I 22-11-0 120.0.0 I 25-0-0 I mU� 0 0(n 2s e0 o 'T , - In ;';;'008 11 1,1 4 � 1 it � x ,2&000 024r. F"I CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION t. jF f fy1�"m NAME OF OWNER- � 1�11yam` CONTRACTOR v Lf DATE INSPECTION RE UESTED i e f - Q TIME INSPECTION REQUESTED • I �' �'`r Pel s PERMIT No.: --I �� TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL COMMENTS: ❑ STATUS CHECK PASSED FAILED ❑ ❑ UTILITIES: ❑ El COMMENTS: ELECTRICAL: ELECTRICAL: ❑ El COMMENTS: SEWER TAP ❑ SEWERm ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE _ PARTIAL ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT PARTIAL PASSED FAILED . ❑ El - PASSED FAILED El El MECHANICAL: ❑ COMMENTS: ROUGH -IN ElA/C ElFURNACE El RADIANTHEAT ElFINAL -1 PARTIAL PASSED FAILED ❑ ❑ PLUMBING: ❑ COMMENTS: F-1 GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PRESSURETEST _ PASSED, FAILED ❑ ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS- INSPECTOR DATHOF INSPECTION MADE - FAXED OPPD�BURT REA _ TO CONNECT SERVICE ON By TIME CTI T 4, 9 ITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION: f, f { P" 4_SI NAME OF OWNER€ `'t =f 1 C`% CONTRACTOR cis? DATE INSPECTION REQUESTED- 1 1 TIME INSPECTION REQUESTEDVIA PERMIT NO_ ; 1' TYPE OF INSPECTION REQUESTED: _ _ _ ❑ CONFERENCE ❑ STATUS CHECI£ BUILDING: � FOOTING ❑ DECI{ FOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIAL PASS D FAILED COMMENTS: ❑ UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ ' COMMENTS: MECHANICAL: ❑ ROUGH—IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL PASSED FAILED ❑ ❑ COMMENTS: PLUMBING: ❑ GROUNDWORK ❑ ROUGH—IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED E]PRESSURE TEST ❑ F1 COMMENTS: , ❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED NOTES/REMARKS- FAXED QPPD�BURTREA TOC, .�41 ❑ GROUNDWORK ❑ I—I PRESSURE TEST ❑ WATER METER INSTALLED PASSED FAILED n `n CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER LOCATION OF INSPECTION• NAME OF OWNER, ° - F, CONTRACTOR DATE INSPECTION REQUESTED t r r �reE1 TIME INSPECTION REQUESTED: PERMIT No:__ r TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE STATUS CHECK BUILDING: ❑ FOOTING ❑ DECK FOOTING ❑ FRAMING ❑ DRYWALL FINAL ❑ PARTIAL PASSED FA D + El COMMENTS:] !7'�. 5 - _ UTILITIES: ❑ SEWER TAP ❑ SEWER ❑SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: �s ELECTRICAL: ❑f ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑TEMPORARY SERVICE ❑ PRECONNECT PASSED FAILED ❑ PARTIAL ❑ ❑ COMMENTS: MECHANICAL: ❑ ROUGH-IN ❑ A/C ❑FURNACE ❑ RADIANT HEAT ❑ FINAL F-1 PARTIAL PASSED FAILED ❑ ❑ ❑ GROUNDWORK ❑ I—I PRESSURE TEST ❑ WATER METER INSTALLED PASSED FAILED n `n 12/10/2006 0230 PM f -W •a,'A AN l0e . �`I'Ior 1ni