BP13459T-06 x CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
gProm{se Permit #
Date: 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
Sign Erecting, Awnings Decks/Handicap Ramps (plot plan required)
Satellite Dishes/Radio Ante n /Cell Towers (plot plan required)
Othera`-i
tilities- ter Public Water: Yes ` No Private Well
If yes, responsible entity: Blair OPPD Line Kennard
1 \ Agreement needed: Date Agreement Received:
Public Sewer: Yes�P No Septic Drawing Provided:
If yes, responsible entity: Blair Kennard
County Road Permit Required: Yes NoSubmitted: Yes No
Additional Description of project if necessary: (g ky ba, (Zs�yY•
11 A^ r in
Project Information:
Job Address: J,qI 5 E Cf%l
l�
/
Legal Description (if applicable)
94= 1
% di%
Owner: \ i4\VfS+fAddress: 10669 Qak P0A1Q(LPhone#:
Contractor: Phone #:
Address: �`1�� \ �`� ,� �\ \� G�,'� Cell:
Email Address for Contractor:
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 or is,66i co pletecfv�ithin two (2) years of date of issue.
S' nature of Own r Contractor 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:
ZoningZFlood Plain/Utilities:
Current Zoning: Conditional Use Permit Required: Yes
Date CUP Approved:
State Fire Marshal Required: Yes No Variance Required: Yes
No
No
Minimum Setbacks: Front Second Front Side Side Rear
Lot Square Footage:
Length x Width: Lot Coverage %
Driveways/Sidewalks:
Sidewalk required: Yes__ No Sidewalk Waiver: Yes No
Date Waiver Approved:
Preexisting Garage requires driveway to be less than 3' from property line:
Approved by:
Flood Plain: Yes No
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
Number of Stories
One Two Three Four
Type of Residential Structure:
Ranch Two Story Split Entry
Rooms Bedrooms Bathrooms
Egress in Basement: Required: Yes No
Sleeping Rooms Living Area
Yes
>Four High Rise (>75 ft)
Raised Ranch Other
_ Fireplaces Gas Electric
Provided on Plans: Yes No
_ Other Egress
Square Footage:
Main Level: Second Level: Third Level
Basement: (Unfinished) (Finished)
Garage: 2 bay 1 3 bay 4 bay_
Detached Garage: Pole Barn:
Addition: Remodel: _
Porch: Front Rear Side
Deck that affect setbacks: Rear Front
Occuoancv Classification:
5+ bay
Side
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
Residential, care/assisted living facilities
Storage, moderate hazard Storage, low hazard Utility, miscellaneous
Is building 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 1311 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 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:
12
$
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $
SW -t- c O -y
ess/Industrial/Educational/Assembly/Fa—ctofy/-Storage/Utility `ueedl- trlfo-"—
*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 ® X $_ $ i �' ' c:)
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$1,000,000
..................................................$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 $
Issuance Fee: $ 25.00 ) , c o
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $ 6
Additional Comments:
Approved by:� �rr�� Date:
v
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:
Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes No
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2003 ICC/ANSI A117.1 COMMENTARY
cur in these rooms (mirrors, coat hooks and shelves)
are also addressed.
603.2 Clearances.
❖ The intent of the clearance requirements is to assure
that a person using a wheelchair can enter the room,
close the door, access the fixtures and exit the room.
Floor drains located in front of accessible plumbing
fixtures can create slopes that cause undesired move-
ment of a wheelchair or walking aid when using
plumbing fixtures (see Section 305.2).
603.2.1 Turning Space. A turning space complying
with Section 304 shall be provided within the room.
d• A 60 -inch (1525 mm) turning circle or a 60 -inch T -turn
space is required within the bathing room or toilet
room. This assures that persons using the room can
turn to address each fixture or operable part they may
need to access. These turning spaces can use knee and
30 X 48 IN. (760 X 1220 mm)
CLEARANCE FOR
LAVATORY
MANEUVERING
CLEARANCE
AT DOOR
60 X 56 IN. (1525 X 1425 mm)
/CLEARANCE AT WATER CLOSET
30 X 48 IN. (760 X 1220 mm)\ 16-18
CLEARANCE FOR
LAVATORY I
MANEUVERING (b)
CLEARANCE
AT DOOR
IDI
Chapter 6. Plumbing Elements and Facilities
toe clearances under the lavatory or toe clearance at the
water closet as indicated in Section 304.3.
603.2.2 Overlap. Clear floor spaces, clearances at fix-
tures, and turning spaces shall be permitted to overlap.
❖ It is important to understand that the clear floor space,
or location where a wheelchair would sit when using a
fixture, is permitted to overlap. However, the fixture
itself cannot overlap the clear floor space of another.
The most common mistake in public single user toilet
rooms is to locate the lavatory adjacent to the water
closet and over the water closet clear floor space.
With the lavatory at this location the clear floor space
required for a side transfer to the water closet is not
available. Because the clear floor space at fixtures and
the turning space are permitted to overlap, portions of
the turning space may extend underneath the lavatory.
See the commentary for Section 604.3.2 and the ex-
amples in commentary Figure C603.2.2.
60 X 561N.
.60 IN. AT WATER
(1525 mm) CLOSET
TURNING CIRCLE
30 X 48 IN. (760 X 1220 mm)
MANEUVERING
SPACE PAST
DOOR SWING
60 X 56 IN. (1525 X 1425 mm)
CLEARANCE AT WATER CLOSET
30 X 48 IN. (760 X 1220 mm)
MANEUVERING
SPACE PAST
DOOR SWING
301N. (760 mm) IF ALCOVE IS
> 241N. (610 mm) DEEP
36"OVE
>F'I%EEP IS 30 X 48 IN. (760 X 1220 mm)
24' DEEP CLEARANCE FOR LAVATORY
Q
116-18.
1�dl .
NOTES
1. MANEUVERING SPACES CAN OVERLAP.
2. APLUMBING FIXTURE CANNOT BE IN THE MANEUVERING SPACE OF ANOTHER FIXTURE.
For SI: 1 inch = 25 mm.
MANEUVERING (�)
CLEARANCE
AT DOOR
Figure C603.2.2
EXAMPLES OF TOILET ROOM PLANS WITH OVERLAP
30 X 48 IN.
(760 X 1220 mm) '
MANEUVERING
SPACE PAST
DOOR SWING
60 IN. (1 526 mm)
TURNING
CIRCLE
113
Department of Justice
4.17 Toilet Stalls
>�ts 18 36 min
18 min 975 16
45s ass 18 min
4S5 1 455
' k
♦�E n E n
Clear : In clear
floor
floor
apace : space
.....«� ..........
48 min
48 min 1220
1210
Fig. 28
Clear Floor Space at Water Closets
215
36 min
12 min 12 min
305 39S
it
=>
tD
Pt. 36, App. A
42 min 18
1055 1 455
clear
floor
apace
min
64 min
1370
12 42 min
305 1055 toilet
paper
p �.
..1
c TChito
!g +<*! j a
BackdWall side wo
F19.29
Grab Bars at Water Closets
4.17.3* Size and Arrangement. The size and
arrangement of the standard toilet stall shall
comply with Fig. 30(a), Standard Stall. Stan-
dard toilet stalls with a minimum depth of 56
in (1420 mm) (see Fig. 30(a)) shall have
wall -mounted water closets. If the depth of a
standard toilet stall is increased at least 3 in
(75 mm), then a floor -mounted water closet
may be used. Arrangements shown for stan-
dard toilet stalls may be reversed to allow
either a left- or right-hand approach. Additional
stalls shall be provided in conformance with
4.22.4.
EXCEPTION. In instances of alteration work
where provision of a standard stall (Fig. 30(a))
42
C N
to
is technically infeasible or where plumbing
code requirements prevent combining existing
stalls to provide space, either alternate stall
(Fig. 30(b)) may be provided in lieu of the
standard stall
4.17.4 Toe Clearances. In standard stalls, the
front partition and at least one side partition
shall provide a toe clearance of at least 9 in
(230_mm) above the floor. If the depth of the
stall is greater than 60 in (1525 mm), then the
toe clearance is not required.
4.17.5* Doors. Toilet stall doors, including
door hardware, shall comply with 4.13. If toilet
stall approach is from the latch side of the stall
door, clearance between the door side of the
533
JPR General Partner, Inc.
10669 Oak Park Lane
Blair, Ne 68008
To: City of Blair - Building Inspector
C7�fe,1s�
PecC IMefri�
Re: Modifications of our rental building @ 695 East Grant Street, Blair, Nebraska
This building was originally built with the option of dividing it into up to four bays of
50' x 50'. The West bay has been separated and is rented to a third party.
This modification will make it into two 50' x 50' bays & one 100' x 50' unit.
The modifications are:
1. The installation of a firewall at the center of the building to separate bays
2&3.
2. The completion of a restroom over existing plumbing.
3. The walling off of a break room.
Bays 1 & 2 have been sitting empty for several months. The new renter will be RSC
Corporation of Houston, Texas an equipment rental company. RSC supplies many kinds
of equipment to the contractors al Cargill which is just across the fence from this
property. It is my understanding that they will use the space for both storage of and
servicing of their various pieces of equipment. It will not be a retail rental outlet.
Time is of the essence and we will be proceeding with the modifications immediately.
Dick's Electric will hand any wiring issues — I have not hired a plumber at this point.
Dick's Electric & whomever I hire, will take out the appropriated permits from city hall.
The plan I have provided defines the modifications we are making — the reason for the 2
x 6 wall between the restroom and the break room is just in case at some point we need
another complete firewall at that location.
James P. Ryan
CITY i, NEBRASKA
Phone 402-426-4191
THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
rvun�
BUILDING PERMIT DEPOSIT AGREEMENT
TA$500-00 r undable deposit is being collected for any new commercial, new
oti8f; 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.
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.
--- ractor/O e
Date
Contractor/Owner
City of Blair
o _
CITY OF BLAIR — APPLICATION FOR BUILDING PERM I mit #
0
a�
'9 PromM1se
Date.
�Q 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
Sign Erecting, Awnings — Decks/Handicap Ramps (plot plan required)
Satellite Dishes/Radio Antenna/Cell Towers (plot plan required) Lp
Other
tjlities- Public Water: Yes entity: :BlairPrlvate _� O Well
Line Kennard
�Q\ If yes, respon y ,
�P 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
Additional Description of project if necessary:
Project Information:
Job Address: q5 E
Legal Description (if applicable)
Owner: F, --�� + n Address: _'10669 ���� P K/rJ(Thone#:_
Contractor:
C Phone #:
Cell 4f-�. \ 5M
Address: \1�
Email Address for Contractor:
Separate permits are required for electrical, plumbing, hearting, ventilating and air conditioning, and septic systems. By my signature
below, 1 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 or is' of c plete ithin two (2) years of date of issue. rr d
�i
S nature of Own r�Contractor 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
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: ( r 0
Permit Fee: $
07100
•
Job Address
Owner Mail Address Zip Phone
1. ( } 11V_21JA�qndYZY
Contractq-) ailAddress �/ (�% Zi 197e ? Phone
2. C
3. Class of Work:_ COMMERCIAL O RESI16ENTIAL O New O Addition Iteration O Repair O Replacement
Describe Work:
4.
PLUMBING PERMIT FEES
Comments:
Modular Home ......................$50.00
Type of Fixture No.
Kitchen.....................$12.00 x
Bath.....R _4dettial/Single Stao 12.00 x o
....................Multi -Stall $25.00 x
Rough -In Bath ........................$8.00 x
Additional Sinks.....................$6.00 x
Slop Sink/Laundry Tray/Drain ..... $6.00 x
Water Heater .........................$10.00 x �_ . 00
Notice
Outside Water Faucet...................$6.00 x
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
Drinking Fountain ........................$6.00 x
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
Backflow/Grease Trap$15.00
Water Service .......................$15.00
state or local law regulating construction or the
performance of construction.
Sewer.................................$15,00
Groundwork .........................$15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System ............ $10.00
Sprinkler System (Commercial).. $3 0.00
'
Gas/Water Piping System
(Commercial)...... ............$50.00
inature of C "tractor or Authorized Agent
Permit Issuance Fee.................$25.00 .
Total q rl 00
Current License on File es O No O N/A
Date
Comment:
WHEN PRUPEKL Y V ALI VA 1 rJJ ALV l til Irl Ak.r,) 1 ni3 tis x v v1�'. r i;iuv_u l
Approved By:
Rev. 2008-10
DATE OF INSPECTION MADE: ---
TO CONNECT SERVICE: UP
7/21/2010 1'0±-
AGES
BUILDING INSPECTION REPORT
❑.-,,_CITY OF BLAIR ❑ WASHINGTON COUNTY ❑ OTHER
LOCATION OF INSPECTION-
NAME
NSPECTION
r t
NAME OF OWNER: CONTRACTOR �:
DATE INSPECTION REQUESTED TIME INSPECTION REQUESTED: e914 `' PERMIT N0.
TYPE OF INSPECTION REQUESTED:
❑ CONFERENCE
❑ STATUS CHECK
BUILDING:
❑ FOOTING ❑ DECK FOOTING
❑ FRAMING ❑ DRYWALL ❑ FFFINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
El
MECHANICAL: ❑
COMMENTS:
PASSED
FAILED
UTILITIES:
❑ SEWER TAP ❑ SEWER ❑
SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑ PARTIAL
GROUNDWORK ❑ ROUGH -IN ""FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
❑
❑
COMMENTS:
TEST
El
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
ASSED
FAILED
F-1PRESSURE
TEST
El
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS•
,A ,0 fs
e-ve
c, a-
c2 ,
INSPECTO®�
DATE OF INSP N MADE:
T
FAXED OPPD\BURT
REA TO CONNECT SERVICE: ON BY