BP13474a
CITY OF BLAIR — APPLICATION FOR BUILDING PERMIT
�P.�}•a° Permit # OLIVI
Date: Approximate Completion Date: s s
Site Plan Attached: REScheck Attached: Complete Plans Attached
_Application for: _Residential Commercial/Industrial _
New Construction Manufactured Nome 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: 1619 19 �J t '0
r)t,Vr c"ter ea.2,d,a
Job Address: 1e1V < G)131 /,,__)V 7 ,e;ei 610 /
Legal Description (if applicable) '% % �� /�' i J 40,,4t
r ,
Owner:c Adh d
11U Address: M153 J c Phone#: q24"' -,5.Z5(
Contractor: � Phone #:
Address: �'#�� ��� 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/ereby agree to perform the pro os work in accordance with the specifications set forth above and in accordance with the
codes/q dina es gf the City of Blair pid th4Sta of Nebraska. I understand that this permit is void if work is not commenced within
/180UsorCilsof 7eted withi o (2) ar date of issue.
...
® _�)
I nature of Owne-rlContrktor 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: IJ 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 %
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
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 No
Sleeping Rooms Living Area Other Egress
Sauare Footage:
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
Occuoancv 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)
x CITY OF BLAIR - APPLICATION FOR BUILDING PERMIT
Permit # / ,3'l%zl
Date: _ b Approximate Completion Date: '?- g ® ".261 O
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)
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 %`3 X /9 l -0 ' U�Y'�-
QV,/ 4 cD��:r�-9.� ,e7cx�iic>' 3u,�y'cx.Zicvr�'ao�urr� uJ cin
Job Address:
Legal Description (if applicable) G X59
/�/�'/�
�%�I� /pd
;;?9 4149/4d
Owner:<Rw
Contractor: Salo
Address:
Address: /-4/59 40 114'y Ls Phone#: q2& -6,:z6&
/,0 aX /-/ roC/ V,
Email Address for Contractor:
Phone #:
Cell #:
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
Inssoector. ereby e to performo
pro s work in accordance with the specifications set forth above and in accordance with the
codes/ dina es the City of Blair d th Sta of Nebraska. I understand that this permit is void if work is not commenced within
/t ys or is oto leted withi o (2) ar date of issue,.
_, _1
L.� _
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
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 X $29
Garage sq/ft area X$25
Total Valuation:
Total Valuation Multiplied by 0.006 =
Issuance Fee:
$ 25.00
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $
Application Date:
ELECTRICAL APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 E 3234
(402) 426-4191
7 -,2 -8 -lo
Permit Fee: $ 0
Job Address / ! / (} f 'Z'
(f zilp /,
MailA�ddrr Phone
Owne&e��
1. U6
Contractor
Mail Address Zip Phone
2.
3. Class of Work: O NEW RESIDENTIAL O NEW COMMERCIAL REMODELING/ADDITIONS O UPGRADE SERVICE
Work: /�aG
j' 7 �r�
4escribe
CSG(�1'% 072-�
5.Current License on File M -Yes O No O N/A Completion Date
ELECTRICAL PERMIT FEES
Service Fee = (Amp Fee + $5.00 per branch circuit)
Upgrade Existing Service.............$25.00
1-100 Amp Fee .......................$25.00
Temporary Service.... ........... $15.00
101-200 Amp Fee .......................$35.00
201-300 Amp Fee .......................$55.00
Fire Alarm System............ ......$15.00
.....
301-400 Amp Fee .......................$75.00
Signs (each)...................... ,,$25.00
401-500 Amp Fee .......................$95.00
Miscellaneous Apparatus .............. $15.00
501-600 Amp Fee.....................$115.00
601-700 Amp Fee.....................$135.00
Commercial/Multi Family and All Upgrades:
701-800 Amp Fee.....................$155.00
801-900 Amp Fee.....................$175.00
# of Circuits x $5.00
901-1000 Amp.........................$195.00
Amp Fee
IF OVER 1000 Amp
1St 1000 Amp Fee..................$195.00
Amp Fee + Circuit Total
Each additional 100 Amps ......... $20.00
New Residential: (Finished Area)
Single/Two Family Dwellings
Notice
5-q 4 sq. ft. x.063 gip. 4
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
Modular/Manufactured Homes ....... $50.00
provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or
Other: (alterations, additions and modifications)
not. The granting of a permit does not presume to give
Receptacles/Switches/Lighting Fixtures (110 volt only)
authority to violate or cancel the provisions of any othcr
# of Apparatus x $1.00
state or local law regulating construction or the
..........
performance of construction.
Power Apparatus (220 Volt or higher)
-711
# of Apparatus...... x $8.00
/
Smoke Detectors..... x $3.00
Signature of 176ntractor or Authorized Agent
Permit Issuance Fee.... .$25.00���.
Total f r
Date
Comment:
WHEN PROPERLY VALIDATED (IN 'PHIS SPACE) THIS IS YOUR PERMIT
Approved By: 2'' 1�2a /
Rev. 2008-10
RECEIVED
2
JUL 27 2010 1.
CITY OF DLAIH 4'-71"
NEBRASKA MW DUAL
3'-10"
PROVIDE CONTINUOUS STRUCTURAL
PANEL SHEATHING ON ALL WALLS
(FOR MORE INFO, SEE NOTES)
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EXISTING WA
`
)
A
4602
WINDOW
N C
Z�
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cq
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� S
i
i RASTERS ABOVE:
SPAN = APPROX. 17'-6"
PITCH = APPROX. 4:12
2x12 ®16 O.C. DFL �2 OR BETTER
o
1
42x72
42x72 42x72 36x80
M
WINDOW
WNDOW WNDO DOOR
2'-9" 3'-6�
3 '-6" S-6-
1.0
1 WALL FRAMIN
SWE:1/4" = 1'-D"
NORTH WAII
EXISTING WALL
LATERAL
USE CONTINUOUS STR
ON ALL SHEATHABLE A
INSTALL PER
WOOD STRUCTURAL SHEATHING MI
INSTALL A80
INSTALL AT CORNS
WALL HEIGHT =
MIN. LENGTH (INTERPOLATED) _
MIN. AMOUNT = EA. END AND 25'
.16
WALL HEIGHT = 8'MIN/14' M
MIN. LENGTH (® 657.)
MIN. AMOUNT = WA. END AND 25'
_ .16
NOTE, LATERAL BRACING I
EXISTING WALL
3"
NOTE: LATERAL BRACING AT EAST END OF SOUTH
WALL IS PROVIDED BY EXISTING WALL. EXISTING SHEA
TO REMAIN. CONTINUOUS STRUCTURAL PANEL SHEATI
PROVIDED AT WEST END AND REMAINDER OF SOUTH
10
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: H 3
Finished sq/ft area a X $ 1A $ 1349 2' ®0
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 $ 00
Issuance Fee: $ 25.00 0�>
Total Permit Fee = Deposit + Permit Fee + Issuance Fee $
Additional Comments:
Approved by: Date: Z-43-10
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
aid:Permit Fee:
Deposit Amount
Receipt #
Deposit Paid by for return to:
Building Inspection Pouch given: Yes No
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O DRAFTING & COORDINATION SERVICES
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Blair,
WASHINGTON STREET,
B 68008
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CITY OF BLAIR, NEBRASKA
Phone 402-426-4191
THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
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WOOD STRUCTURAL PANEL
(INSTALLED IN ACCORDANCE
WITH TABLE 602.3(1)
8d NAIL 012' O.C.
ALL FRAMING MEMBERS \
NOT AT PANEL EDGES)
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16d NAIL 0 24" O.C.
L
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SCALE: 3/4" = 1'-0"
WALL DETAIL @-
SCALE: 3/4" = 1'-0"
8d NAIL 012" O.C.—
(ALL FRAMING MEMBERS
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8d NAIL 0 6' O.C.
(ALL PANEL EDGES)
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TH TABLE 602.3(1)
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B1 CORNER DETAIL
SCALE: 3/4" = 1'-0"
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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.
wner/Occupant
City of Blair
Contractor
to
oaPoar—..
218 South 16th Street • Blair, Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 • E-mail cltyofblair@ci,blair.ne.us
7/16' MIN. OSB ROOF SHEATHING
(SPAN RATING 24/0 MIN.)
6d NAILS 0 6' MAX @SUPPORTED EDGES
CONTINUOUS 2 X BLOCKING
BETWEEN RAFTERS (TYP.)
DIAPHRAGM
NAILING (1)
2'-0'
wf 0 e- WALL COVERING OVER---,
7/16' OSB WALL SHEATHING
6d NAILS 0 6' PANEL EDGES
5/8' DIAMETER ANCHOR BOLTS
18' MIN. LENGTH
0 C–O' o.c. MIN.
EXTERIOR GRADE
EL.= 0.-0"
EL.=
WALL SECTION
SCALE: 3/4" = l'—O"
SIMPSON RR RIDGE
RAFTER HANGER OR
EQUIVALENT
12
4
(APPROX,)
2x12 LEDGER I i
SCREW AND LAG–BOLT
AT EA. EXISTING STUD
2x12RAFTERS
TEXISTING WALL -j
D O
2 R BETTER
RAFTER–WALL CONNECTION: I
(4) 16d NAILS (.162- DIA. x 3.5*) TOENAILED INTO
DOUBLE TOP PLATE
TOENAILS SHALL BE DRIVEN AT AN ANGLE OF 30 DEGREES WITH THE MEMIE
AND STARTED 1/3 OF THE DISTANCE FROM THE MEMBER END
STRAP TIE: SIMPSON MTS12 OR EQUIV. RECEIVED
INTERIOR WALL COVERING JUL
BEARING WALL: r'lly Of BLAIR
2x6 016' O.C. jAEBRpSKA
(8, STUDS)
— 2x6 SILL PL
(PRESSURE TREATED)
EXISTING FOUNDATION, FOOTINGS
ID SLAB (PREVIOUSLY APPROVED)
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 r fundable deposit is being collected for any new commercial, new
, 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.
Contractor/Owner Contractor/Owner
City of Blair
ate