AD-2010-00276 (2).tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding P ermit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
AD - 2010 -00276 A ' °m is of www.blairnebraska.org
12/17/2010 ADDITION Residential January 3, 2011 7
LOCATION OF IMPROVEMENT: 1273 Voss Dr, Blair, NE 68008
ARCHITECT: GENERAL Malibu Sunrooms & Outdoor Living, LLC
OWNER: Tammmy L Dunker CONTRACTOR: 13633 S 217th St
1273 Voss Dr Gretna, NE 68028
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 12/16/2012
1273VossDr- 101217- SunroomAddition ESTIMATED COMPLETION DATE
2010 -12 -17
DESCRIPTION OF WORK
20x16 Sunroom addition will have electric, no heating, cooling or plumbing.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
_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 th. es /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or without tention of the undersigned or any alteration or change from this application without approval of the
Buildin cil shall n ii sufficient ground for the revocation of any permit issued which was based on the approval of this
°`p icati�n.`
Signa{ reofA plica ate
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BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 r undable deposit is being collected for any new commercial, new
residential, nd 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.
°C ntractor /Owner Contractor /Owner
City of Blair
Date