AD-2010-00147.tif i
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426- 4195 - FAX
AD -2010 -00147
to h�se 01 0 www.blairnebraska.org
10105/2010 ADDITION Residential October 14, 2010
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b vy LOCATIONOFIMPROVEMENT: 1155 N. 18th Ave, Blair, NE 68008 j
®r ARCHITECT: GENERAL Warrick Construction Co.
a . OWNER: Rob Williams CONTRACTOR: 1114 James Dr
1155 N. 18th Ave Blair, NE 68008
Blair, NE 68008
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NATURE OF WORK PROPOSED USE
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 04111/2011
1155N.18thAve- 101005 - Addition ESTIMATED COMPLETION DATE 2010 -12 -01
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DESCRIPTION OF WORK
12 x 12 Storage Shed to be attached to garage. j
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COM check SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 j
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
B u 'Iding Official, shat constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ap lication. ?
Date
Signature of Applicant
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promise
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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 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.
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Contractor/ caner Contractor /Owner
City of Blair
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Date
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C1', Of F)LAIQ
"rise of a
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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
code items. Also, it is your responsibility to know the 2006 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.
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Owner /Occupant Contractor
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City of Blair Date
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218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cilyofblair @cl,blair,ne,us aPOa.x "Y
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CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191- Phone
(402) 426 -4195 - FAX
www.blairnebraska.org
/se 01 ava
PERMITNUMBER: AD- 2010 -00147 EXPIRATION DATE: 10/20/2012
ISSUED: 10/21/2010 PAYMENTMETHOD: Check
PERMITTYPE: ADDITION RECEIPT NO. 2010 -00188
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NAME OF PROJECT: 1155N. 18thAve- 101005- Addition PARCEL # j
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1155 N. 18th Ave
JOBSITEADDRESS: Blair, NE 68008 LOT
TYPE OF WORK: BLOCK
Addition
JOB COST: $9072.00 TOTALFEE: $ 387.00
USE GROUP:
DEPOSIT:
IN PURSUANCE OF THE FILING OF THE REQUIRED APPLICATION AND PLANS AND SPECIFICATIONS BY:
PRIME CONTRACTOR: OWNER:
Warrick Construction Co., Warrick Construction Co. Rob Williams
1114 James Dr 1155 N. 18th Ave
Blair, NE 68008 Blair, NE 68008
402 - 426 -2996
PERMISSION IS HEREBYGRANTEDTO:
12 x 12 Storage Shed to be attached to garage.
# OF STORIES: 0 # OF BEDROOMS: 0 #OF BATHROOMS: 0
TOTAL LIVING SQ. FT: 0 TOTAL UNFINISHED BASEMENT SQ. FT: 0
TOTAL FINISHED BASEMENT SQ. FT: 0 TOTAL GARAGE SQ. FT: 0
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN SIX (6)
MONTHS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF SIX (6) MONTHS AT ANY
TIMEAFTER WORK IS STARTED, OR IF WORK IS NOTCOMPLETED WITHIN TWO (2) YEARS OF DATE OF ISSUE.
NO PREMISES SHALL BE OCCUPIED UNTIL A CERTIFICATE OF USE AND OCCUPANCY OR A WRITTEN CONDITIONAL
OCCUPANCY APPROVAL BY THE BUILDING OFFICIAL HAS BEEN ISSUED. THIS PERMIT DOES NOT AUTHORIZE ANY
ENCROACHMENTONPUBLICPROPERTY.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING AND AIR CONDITIONING AND
SEPTIC SYSTEMS. ALL WORK WILL BE PERFORMED 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.
THE ISSUANCE OF THIS PERMIT IS FOR THE WORK SPECIFIED IN THE APPLICATION FILED. THEREFORE ANY
UNAUTHORIZED CHANGE OR ALTERATION FROM THE AFORESAID APPLICATION OR PLANS WILL RENDER THIS PERMIT
NULL AND VOID. ALL CORRECTIONS OR ALTERATIONS NOTED IN ANY ADDENDUMS ISSUED BY THIS DEPARTMENT
SHALL BE MADE A PART OF THE APPROVED PLANS AND SHALL BE PERFORMED AND INCORPORATED INTO THE WORK.
THE ISSUANCE OF A BUILDING PERMIT, OR THE ISSUANCE OF AN APPROVED SET OF PLANS DOES NOT ABSOLVE THE
OWNER, ORCONTRACTORFROM COMPLYING WITHALL.
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BY: HOWARD WOLFE
CITY BUILDING INSPECTOR /CODE ENFORCEMENT OFFICER
MUST POST ON JOB SITE IN A VISIBLE LOCATION