PL-2010-00132_0001.tif i
CITY OF BLAIR
218 S. 16TH STREET j
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
PL- 2010 -00132 Ar�M /ae of Q� °���J (402)426 -4195 -FAX
www.blaimebraska.or g
09/27/2010 PLUMBING Commercial September 27, 2010
LOCATIONOFIMPROVEMENT 1060 Wilbur St, Blair, NE 68008
ARCHITECT:
GENERAL Jensen Plumbing & Heating, Inc.
OWNER: Papio Natural Resource Dist CONTRACTOR: PO Box 196
8901 South 154th St Lyons, NE 68038
OMAHA, NE 68138 -0000
NATURE OF WORK PROPOSED USE
Misc. Permit Office Building
PROJECT NAME PERMIT EXPIRES 03/26/2011
1060WilburSt- 100913 -New Commercial
ESTIMATED COMPLETION DATE 2010 - 03 - 01
DESCRIPTION OF WORK
Plumbing for Interior, 6" water main tap with fire line and 2" meter. Water and Sewer Service also.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
RESchecklCOMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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
application.
Signature of Applicant Date
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