MS-2014-00256.tif i
ter:
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 -Phone �
MS- 2014 -00256 (402) 426 -4195 - FAX
�1se of a www.blairnebraska.org
05/30/2014 MISC Residential May 30, 2014
LOCATION OF IMPROVEMENT: 1028 South St, Blair, NE 68008
a ARCHITECT:
ry GENERAL Donald Andersen
t OWNER: Charlotte J And Rodger K Bauer CONTRACTOR: 410 Co Rd M
1064 South St Oakland, NE 68045
` BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Roofing /Soffit/Eaves /Gutters Accessory Buildings
PROJECT NAME PERMIT EXPIRES 05/29/2016
1028SouthSt- 140530- Roofing ESTIMATED COMPLETION DATE 5/30/2014
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DESCRIPTION OF WORK
Tearing off and replacing with asphalt. 2 garages.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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1. No work will be started before a permit is ISSUED AND POSTED.
2. For commercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit application does not constitute issuance of
this building permit. It is further understood that construction covered by this permit application shall not be commenced until a
copy of a permit signed by the Building Inspector is issued.
5. The undersigned owner or agent agrees 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. Any omission of or misrepresentation of
fact with or without the intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic tion
Signature of Applicant Date
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C
ar ° mise of 0 � 1
ROOF PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and /or roofing permit requirements. It in no way includes ALL particular
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code items. Also, it is your responsibility to know the 2009 International Building
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
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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 &Lontractor
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City of Blair ate
218 South 16th Street •Nair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cltyofblair @cl.biair,ne.us o:Powr LAITY
CITY OF BLAIR, NEBRASKA
Phone 402 -426 -4191
RECEIVED OF:
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ADDRESS
CITY, STATE ZIP CODE
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THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO {
RECEIVED BY
Pounds Printing, Bieir, NE 68008
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promise
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 ccessory building valued under $10,000.
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L A$50.00 r undable 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.
n Contractor /Owner
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City of Blair
v / �
to
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2009 INTERNATIONAL RESIDENTIAL CODE
CITY OF BLAIR REROOFING
Return to Blair City Hall prior to Final Inspection
218S16 th Street, Blair, NE 68008
Because of limitations caused by the infeasibility to perform detailed inspections which would
not interfere with reroofing work, please indicate compliance with the following requirements
following this reroofing job.
Permit #: f
3 5z c-
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Installation Date: j
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YES NO
❑ The materials and methods of application used for recovering or replacing the existing
roof covering comply with the requirements of the building code. (R907.1) j
® ICE PROTECTION INSTALLED An ice barrier that consists of at least two layers of
underlayment or of a self - adhering polymer modified bitumen sheet was installed and
extends at least from the eave's edge to a point at least 24 inches inside the exterior
wall line of the building. (R905.2.7.1)
® STRUCTURAL COMPONENTS ARE SOUND: The structural roof components are
capable of supporting the roof covering system and the material and equipment loads
that will be encountered during installation of the roof covering system. (R907.2)
❑ EXISTING COVERING WAS REMOVED: Existing roof covering was removed for one
of the reasons required by section R907,3
® NO RUSTED METAL OR FLASHING: Existing vent flashing, metal edges, drain
outlets, collars or metal counter - flashing were not reinstalled if rusted. (R907.5)
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❑ FLASHING INSTALLED PROPERLY: Flashing shall be reconstructed in accordance
with approved manufacturer's installation instructions. Metal flashing to which
bituminous materials are to be adhered shall be primed prior to installation. (R907.6)
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S gnature of Primary Installer Date
Date
ignature of Permit Holder
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