BP13379CITY OF BLAIR — APPLICATION FOR BUILDING PERMIT
w .gpromize° p Permit # �'_-2 f -1i
Date: �" a;2 Approximate Completion Date: a'
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 pian 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
Additional Description of project if necessary.
Project Information:
Job Address:
a) Cy / -<,,- XV
947049 / 7&
Legal. Description (if applicable)
Owner: Address: Z d") g sr � Phone#:
Contractor: /� /u G�/L�r Phone #:
-
Address:
Email Address for Contractor: ezll o 6 Al cfE' /ate . c%acv
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
a or is not completed withi two years of date of issue.
l
Signature of wner/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
R
Signature of Owner/Contractor 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 I 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
jype of Residential Structure:
Ranch Two Story Split Entry _
Rooms Bedrooms Bathrooms
Egress in Basement: Required: Yes
Yes
>Four High Rise (>75 ft)
Raised Ranch Other
Fireplaces Gas Electric
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
Detached Garage: Pole Barn:
Addition: Remodel:
Porch: Front Rear Side
Deck that affect setbacks: Rear Front Side
5+ bay
Occupancv 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, 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 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)
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
Issuance Fee:
Multiplied by 0.006 =
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $-
RESIDENTIAL - ADDITIONS / REMODELS and
COMMERCIAL - NEW CONSTRUCTION / ADDITIONS / REMODELS:
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:
Accesso!y 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 e d X $ $ 1. �� ��
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
$25,001 TO $50,000
........................................................ $70
......................................................$370
+$13
+$10
per additional $1,000
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
$ CO3 b,5q . q
Issuance Fee:
$ 25.00 �r
Total Permit Fee = Deposit + Permit Fee + Issuance Fee
$ r11
Additional Comments:
Approved by: IL1644k
Date'
f
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
CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
RECEIVED OF:
v
ADDRESS
CITY, STATE, ZIP CODE
j,
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BUILDING PERMIT DEPOSIT AGREEMENT
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.
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.
UC
oq
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Date
Contractor/Owner
i
Ci of lair
bro�/se of a`�a\`
CITY Of BLAIQ
BUILDING PERMIT SUPPORTING DOCUMENTS
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 Building
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.
Owner/Occupant
City of Blair
QLi'- "/ -
Contractor
QV JL)L IL2
Date
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cityofblair@ci.blair,ne.us
]BUILDING INSPECTION REPORT,
;CITY OF BLAIR ❑ WASHINGTON COUNTY IZ ❑ OTHE 7,
LOCATION OF INSPECTION -
NAME OF OWNER ° ` f <• CONTRACTOR:
DATE INSPECTION REQUESTED Lfl TIME INSPECTION REQUESTED -_.
r
PERMIT NO
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ 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
El
ElCOMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
F1
PARTIAL
❑
F1COMMENTS:
MECHANICAL: ❑
ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED
FAILED
❑
❑
COMMENTS:
PLUMBING: ❑
GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
PASSED
FAILED
F-1
PRESSURETEST
E]
ElCOMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
INSPECTOR•_�__� DATE OF INSPECTION MADE: CJ I o
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
J 37�
IMR tp �. Nq• IIM
I W *I
n
4/27/2010 1 M 04027-10
Christopher Holmes
NNE Pharmaplan
3005 Carrington Mill Blvd, Suite 380
Morrisville, NC 27560-
(919) 699-1747
NEBRASKA STATE FIRE MARSHAL ;
PLANS DIVISION `�� ����s
Code Review Jfl
ti lis
Novozymes Blair C - Mixing Building NEM
600 S First Street W
Blair 68008 -
Your items have been reviewed for compliance with the Nebraska State Fire Marshal Act.
0 • 6".11=9111111M. 0 • • . -11"...-H - "11111101
Final Architectural Plan New Building
REMARKS:
Approved as submitted.
Return postage is not provided. Please contact this office within 10 days if you intend to pick up plans or
send return postage. If contact is not made, plans will be discarded after 10 days.
Alt Phone:
Occupancy Type: Industrial
Estimated Start Date: 4/28/2010
Fire Protection Features:
Email: CIHO@nnepharmaptan.com
Construction Type: Type II -A 8,300 SF
Estimated Completion Date: 2/20/2011
Sprinkler Total Spinkler Partial ❑ Range Hood System ❑ Sprinkler Other:
Fire Alarm Manual Sys. ❑ Smoke Detection Fv-1 Heat Detection ❑ Fire Alarm Other:
Page I of 1
PLEASE CONTACT OFFICE INDICATED BELOW FOR A FINAL INSPECTION.
FINAL ONSITE APPROVAL IS REQUIRED PRIOR TO OCCUPANCY OR USE.
Reviewed By: Main Office
246 South 14th Street
Lincoln, NE 68508-1804
(402) 471-2027
David Autry
Contact for Inspection: District B
438 W Market
Albion NE 68620-1241
(402) 395-2164
BUILDING INSPECTION REPORT,
❑--CITY OF BLAIR
❑ WASHINGTON COUNTY ❑ OTHE 1
o.
LOCATION OF INSPECTION
NAME OF OWNER
CONTRALTO', _
1>
DATE INSPECTION REQUESTED -} c TIME INSPECTION REQUESTED i„ PERMIT NO y
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECK FOOTING] ❑ FRAMING 1:1 DRYWALLS ❑ FINAL ❑ PARTIAL
PASSED
FAILED
COMMENTS:
k` / MVV r ` l �� I d�✓d
(/
WWATER
❑
UTILITIES: ❑
SEWER TAP ❑ SEWER ❑ SEPTIC ❑ TAP ❑ REMOTE ❑ WATER SERVICE
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
ELECTRICAL: ❑
ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
PASSED
FAILED
❑
PARTIAL
❑
❑
COMMENTS:
MECHANICAL: ❑ ROUGH -IN ❑
COMMENTS:
❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
PASSED FAILED
❑ ❑
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN; ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
❑ PRESSURE TEST ❑ ❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
INSPECTOR: _ DATE OF INSPECTION MADE: �(J TIME
FAXED OPPDIBURT REA TO CONNECT SERVICE: ON BY
I 'plH I N U 1 .0 --al
-0,"CITY OF BLAIR
❑ WASHINGTON COUNTY ❑ OTHER
LOCATION OF INSPECTION ' �
4
NAME OF OWNER•
p
� Y CONTRACTOR•
DATE INSPECTION REQUESTED
t w
.; s'
-° °� �� IME INSPECTION REQUESTED ° ` 3 0' PERMIT NO-
O
,
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE
TYPE
❑ STATUS CHECK
BUILDING: ❑
FOOTING ❑ DECKFOOTING ❑ FRAMING ❑ DRYWALL ❑ FINAL ❑ PARTIALS
tPASSED
FAILED
{
El
COMMENTS tr 9
t.0 t /,i :�, , x
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 El FURNACE ❑ RADIANT HEAT ❑ FINALS❑ PARTIAL
PASSED
FAILED
❑
❑ }
COMMENTS:
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL PASSED FAILED
❑ PRESSURE TEST ❑ ❑
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
® 'A Rr®
NOTES/REMARKS:
INSPECTOR. �� DATE OF INSPECTION MADE: �` 7- c TIMF. Z.47
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
CITY OF BLAIR
❑ WASHINGTON COUNTY ❑ OTHER
p ter` �..'
r
LOCATION OF INSPECTION:
t.`
L L ,' ',,(,Vi b`„'.,
NAME OF OWNER " ��;
-� � '
CONTRACTOR- - '
d
' ''
'� "
DATE INSPECTION REQUESTED:
�� _` F
TIME INSPECTION REQUESTED_ e� PERMIT N0 ;
TYPE OF INSPECTION REQUESTED: ❑ CONFERENCE ❑ STATUS CHECK
BUILDING: ❑„ FOOTING F] DECKFOOTING [:1FRAMING [IDRYWALL ❑ FINAL ❑ PARTIAL ASSED FAILED
COMMENTS:w✓" ❑
UTILITIES: ❑ SEWER TAP ❑ SEWER ❑ SEPTIC ❑ WATER TAP ❑ REMOTE ❑ WATER SERVICE
❑ PARTIAL
COMMENTS:
ELECTRICAL: ❑ ROUGH IN ❑ FINAL ❑ PERMANENT SERVICE ❑ TEMPORARY SERVICE ❑ PRECONNECT
❑ PARTIAL
COMMENTS:
MECHANICAL: ❑ ROUGH -IN ❑ A/C ❑ FURNACE ❑ RADIANT HEAT ❑ FINAL ❑ PARTIAL
COMMENTS
PLUMBING: ❑ GROUNDWORK ❑ ROUGH -IN ❑ FINAL ❑ WATER METER INSTALLED ❑ PARTIAL
❑ PRESSURE TEST
COMMENTS:
❑ OCCUPANCY GRANTED ❑ CONDITIONAL OCCUPANCY GRANTED
NOTES/REMARKS- C
1i✓IZi9%C QtJ 133 L4 5
PASSED FAILED
❑ ❑
PASSED FAILED
❑ ❑
PASSED FAILED
❑ ❑
PASSED FAILED
❑ ❑
INSPECTOR �+� il�� DATE OF INSPECTION MADE: 7r ( o TIME
FAXED OPPD\BURT REA TO CONNECT SERVICE: ON BY
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