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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