BP13455Site Plan Attached: --" REScheck Attached: Complete Plans Attached L--
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)
Other
Utilities: Public Water: Yes No _
If yes, responsible entity:
Agreement needed:
Public Sewer: Yes No _
If yes, responsible entity:
County Road Permit Required: Yes No _
Additional Description
J �c4
project if necessary. /;a/
Project Information
lob Address: �� ��`�
Legal. Description (if applicable) —n
Owner: 1< CL ,1V1
_ Private Well
Blair OPPD Line Kennard
Date Agreement Received:
Septic Drawing Provided:
Blair Kennard
Submitted: Yes No
�`°C."ttd
Address: °y''�'�`� Phone #:
Contractor: c r�
Address: °G'l" e '
Phone #:
Cell #:
Email Address for Contractor: 1 ye- n(Aa c n 610 51 e ,L67tYi
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
p� .1$0 days or is not completed within two (2) years of date of issue.
Signature of Owner ntractor 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. 6 --
ign re of Owner/ ntractor Date m / l c
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 I 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: Yes
Approved by:
Flood Plain: Yes No
If yes, specify special requirements:
BUILDING INSPECTOR REVIEW:
Number of Stories
One Two Three Four >Four
Type of Residential Structure:
Ranch Two Story Split Entry
Rooms Bedrooms Bathrooms
Egress in Basement: Required: Yes No
Sleeping Rooms Living Area
Sauare Footage:
Raised Ranch
High Rise ( >75 ft)
Other
Fireplaces Gas Electric
Provided on Plans: Yes
_ Other Egress
M
Main Level: Second Level: Third Level
Basement: (Unfinished) (Finished)
Garage: 2 bay 3 bay 4 bay 5+ bay
Detached Garage: Pole Barn:
Addition: Remodel:
Porch: Front Rear Side
Deck that affect setbacks: Rear Front Side
Occupancv Classification:
Assembly, theaters, with stage _
Assembly, nightclubs
Assembly, churches
Assembly, general, community ha
Business Educational _
Factory and industrial, low hazard
Assembly, theater, without stage
Assembly, restaurants, bars, banquet halls
Assembly, arenas
Ils, libraries, museums
Factory and industrial, moderate 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 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 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
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $
Business / Industrial / Educational / 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 $2000)
Construction valuation computation l 7 bold � 66
Finished sq/ft area X$ $ "`
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
$ L f 1)0
Issuance Fee:
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
$ / 0 CI
Additional Comments:
Approved by:
Date:
�� � _ i 0
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: U— — i /.� ash . 6`'°
Deposit Amount 0
Receipt # P �, ti
Deposit Paid by for return to:
Building Inspection Pouch given: Yes _ No
LZAN41111{'il
BUILDING PERMIT DEPOSIT AGREEMENT
Q: A$500.0 0 fundable deposit is being collected for any new commercial, new
dential, and any additions, remodels and accessory building valued $10,000 or
4reater 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.
7, ) 6,
` Contractor /Own
Contractor /Owner
City of Blair
Date
June 8 2010 FILE COPY RECEIV
Reference: Pipe Rack Addition Blair Terminal
Terra Nitrogen
Blair Terminal
250 Industrial Park Drive
Blair NE. 68008
(402)- 426 -4164
Howard Wulf
City of Blair Building Inspector
cc: State Fire Marshall
Dear Howard
JUN 00 2010
i
As we discussed this morning the bolting for the pipe rack will be tensioned
per ASME PCC -1 Guidelines for Pressure Boundary Bolted Flange Joint
Assemblies. All bolting will be tensioned to the guidelines set forth in the
above mentioned ASME code and will tensioned by a third party bolt
tensioning company who will certify that bolting is to the proper torque.
Bolt torque will be documented and signed by Terra Nitrogen Inspection
Department along with the contractor of installation and the third party bolt
tensioning company.
H TOw4
Herb Townsend
Terra Nitrogen
6606 East 540 Road
Claremore, OK 74019
(918) 230 -7428
BUILDING INSPECTION REPORT
❑ WASHINGTON COUNTY F
LOCATION OF INSPECTION
NAME OF OWNER-
Z' CONTRACTOR
wo
DATE INSPECTION REQUESTED:
TIME INSPECTION REQUESTED_ X' AN
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING:
WALL ❑ FINAL F PARTIAL
PASSED
FAILED
El
COMMENT
UTILITIES:
P ❑ REMOTE F WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL F PERMANENT SERVICE ❑ I TEMPORARY SERVICE❑ PRECONNECT
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
F
1
COMMENTS:
PLUMBING: F
GROUNDWORK ❑ ROUGH-IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
❑
PRESSURE TEST
❑
F
COMMENTS:
F OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS
INSPECTORL--- DATE OF INSPECTION MADE: 7-70-1(o TIME AllL
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON B