CN-2010-00178_0001-1.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Pe1" It Application (402) 426- 4191 - Phone
(402) 426 -4195 - FAX
RN- 2010-00178 ° " l;se of www.blairnebraska.org
10/21/2010 RES -NEW Residential October 21, 2010
LOCATION OF IMPROVEMENT: 1192 S 13th Ave, Blair, NE 68008
ARCHITECT:
GENERAL Les Johnsen Construction LLC
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OWNER: Les Johnsen Construction Inc CONTRACTOR: 902 Meadow Dr
902 Meadow Dr Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Primary Structure
PROJECT NAME PERMIT EXPIRES 10120/2012
1192S 13thAve- 101021 -1
ESTIMATED COMPLETION DATE 2011 -05 -31
DESCRIPTION OF WORK
Residential New Construction -3 bedrooms, 2 bath, unfinished basement with bath rough -in, 10x30 rear wood deck,
19x5 concrete stoop in front, 3 car garage
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheckSUBMITTED: Received
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
ININ 1.11
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 con titVt6 ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of App ) ant
Date
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