AD-2010-00157.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 -4191 -Phone
(402) 426 -4195 - FAX
AD- 2010 -00157 iSe °i q www.blairnebraska.org
10112120 ADDITION Commercial October 12, 2010
LOCATIONORMPROVEMENT: 193 Grant St, Blair, NE 68008
3 ARCHITECT:
GENERAL Jorgensen Contracting
OWNER: Robert W And Bernice Pearson CONTRACTOR: 628 Front St
�7 2113 Washington St Blair, NE 68008
BLAIR, NE 68008 -0000
+` .? ':a;. r "
'
rG"'.. T . � r ' 'x "'�q3 S 1, y -� >✓^��.te '^, z „ lfi � r f : rs�rt '}
_ ..,Zi - ., q'" u ti,:. ��...� :
_ a a, d r — 0,10 N, r,s
? n-
` ��r-.
..,,..��.,r,.,., ,. ,. .«... ...,.,,.w. .. .,. ,
NATURE OF WORK PROPOSED USE
Addition Primary Structure
PERMIT EXPIRES 10111/2012
PROJECT NAME
193GrantSt- 101012 -1 ESTIMATED COMPLETION DATE 2010 -07 -01
DESCRIPTION OF WORK
Addition to each end of existing building East end 27'x30' =810 sq ft; West End - 27'x12' =324 sq ft
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
L -AN 011W k p g ,
gp
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
ilding Official, shall constitute sufficient grou he revocation o any permit issued which was based on the approval of this
ap lication.
w.
gna ure of Applicant _ Date