BP13476CITY OF LAI - APPLICATION FOR BUILDING PERMIT
goao Permit #
Date: Approximate Completion Date:
Site Plan Attached: REScheck Attached: Complete Plans Attached -y
p x ,.
Application for _ Residential Commercial /Industrial
New Construction Manufactured Home Modular
Move -on: Home Accessory Building Other
WX . R gar,
Accessory Building: Garage Pole Barn Other
Floor Type: Dirt Concrete Electricity: Yes No
Sign Erecting, Awning " -Decks/Hand ' icap Ramps (plot plan required)
Satellite Dishes /Radio Antenna /Cell Tower (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 of project if necessary
t
Project Information
Job Address:
Legal Description (if applicable) �( .
Owner:
Contractor:
Private Well
Blair OPPD Line Kennard
Date Agreement Received:
® Septic Drawing Provided:
Blair Kennard
Submitted: Yes No
rasa {
/� S rw
lZ
Phone #: -
Phone #: r�
e
Address: `_ i ` ` 9 Cell #:
Email Address for Contractor:
Separate permits are required for electrical, plumbing, heating, 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 not completed within two (2) years of date of issue.
Signature of Owner /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:
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 i vewa vs /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
Type of Residential Structure:
Ranch Two Story Split Entry
Rooms Bedrooms Bathrooms
>Four High Rise ( >75 ft)
Raised Ranch Other
Fireplaces Gas Electric
Egress in Basement: Required: Yes No Provided on Plans: Yes
Sleeping Rooms Living Area Other Egress
Sauare Footage:
Occunancv Classification:
Assembly, theater, without stage
Assembly, restaurants, bars, banquet halls
Assembly, arenas
Ils, libraries, museums
Factory and industrial, moderate hazard
High Hazard, explosives
Assembly, theaters, with stage
Assembly, nightclubs
Assembly, churches
Assembly, general, community ha
Business Educational
Factory and industrial, low hazard
No
(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. 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
Garage sq/ft area
Total Valuation:
Total Valuation
Issuance Fee:
X $29
X $25
Multiplied by 0.006 =
H
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $
ess/ 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
Finished sq/ft area X $ $ Z
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
$ ,Z�
Issuance Fee:
$ 25.00
Total Permit Fee C Deposit + Permit Fee + Issuance Fee
$
Additional Comments:
Approved by: x
Date:
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 F I A iR NEBRASKA
A
Phone 40 •
Pounds Printing, Blair, NE 68008
m
I Z.
4-
r
- n T
> -f
PQ
to
<
�3
C r
m
m
I
- n
--q --I
i
i
�!
i
i
i
a ,
-,:;, m
m -
zoom
X
>
C
> < w �z
U)
O
Z
COZ
W
CO CD >
c
m
0
>
o
In
(Dm Z
, � \u
-ILI
0
Iff
E
H
IN-M
T o
t-j I I
--q --I
i
i
�!
i
i
i
a ,
-,:;, m
m -
X
>
m
0
O
W
c
m
>
In
;u
>
zmm
>
>
Z
r)
Cf > C/)
0
0 2
q of
A
>
w
> m
x
r
r-
G)
0 M
M
C
m -
0
1 � 2 6
Z
C
>
Ol
o
:>Z,
o I z
o C) I
0 m
:E 0
m
M
H
IN-M
T o
t-j I I
Howard Wolfe
From:
Anne Shotwell [signdepot @huntel.net]
Sent:
Wednesday, July 07, 2010 4:47 PM
To:
Howard Wolfe
Subject:
Re: King Buffet sign -210 S. 8th. St.- Blair- 7 -7 -10
Attachments:
image001.png
Dear Howard Wolfe,
Good Morning,
Here you go they are the same as before on the
Blair Book Store and the Blair Dance Studio.
We will be using 3 " Toggle Bolts 1/4" in Diameter.
The sign will weight Approx. 100 lbs.
It will be affix to an aluminum raceway which will be attached the fasia of the building.
Judt Electric will be pulling the eletrical permit for final sign hook -up.
Thank you so very much,
I hope this answers all your questions.
Anne Shotwell
Sign Depot
Blair, NE
402 - 426 -8052
- - - -- Original Message - - - --
From:
To:
Sent: Wednesday, July 07, 2010 11:35 AM
Subject: King Buffet sign -210 S. 8th. St.- Blair- 7 -7 -10
Please provide the following information so I can complete the plan review process:
1. Show fastener type, length and diameter. Show location of fasteners. Show what type of structure they are
fastened to (plywood etc.).
2. How much doe's the sign weigh?
Howard Wolfe
Building Inspector
City of Blair
218 South 16th Street
Blair, NE 68008
Office: (402) 426 -4191
Direct: (402) 426 -6696
Fax: (402) 426 -4195
1
Howard Wolfe
From: Howard Wolfe
Sent: Wednesday, July 07, 201011:35 AM
To: Isigndepot @huntel.net'
Cc: Howard Wolfe
Subject: King Buffet sign -210 S. 8th. St.- Blair- 7 -7 -10
Attachments: image001.png
Please provide the following information so 1 can complete the plan review process:
Show fastener type, length and diameter. Show location of fasteners. Show what type of structure they are fastened
to (plywood etc.).
2. How much doe's the sign weigh?
Howard Wolfe T r € '
Building Inspector t-
City of Blair
218 South 16th Street
Blair, NE 68008
Office: (402) 426 -4191
Direct: (402) 426 -6696
Fax: (402) 426 -4195
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
q
Additional Description ofyroject if necessary
Project Information
Job Address:
Legal Description (if applicable)
Owner:
Contractor:
Address:
dress: C -) S 8 ?ti c Phone #: Z/96 s 4500-q-3
n
Phone #: /V _;;,& — 19 6
f �� 13 / � 1
Cell #:
Email Address for Contractor:
Separate permits are required for electrical, plumbing, heating, 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
7.80_-Oays or is not completed within two (2) years of date of issue.
(A kx - 7- 1
Signature of Owner /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
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
4
Allk
City of Blair
Contractor
Date
218 South 16th Street • Blair, Nebraska 68008 • 402 -426 -4191 • Fax 402 - 426 -4195 • E -mail cityofblair @ci.blair,ne,us
- 'nise of a"
M VIM -
nIm"D 0150:2:1V NI I dol �IMAU
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.
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.
Contractor /Owner
Contractor /Owner
y of Blair
71�
Date