RE-2012-00024_0001.tif i
CITY OF BLAIR
ti 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
RE - 2012 - 00024 an oaa www.blairnebraska.org
0210312012 REMODEL
7777�_
Residential February 7, 2012
i
LOCATIONOFIMPROVEMENT: 897 Southfork Rd, Blair, NE 68008
ARCHITECT: GENERAL Stutz Construction Inc.
,_.. OWNER: Duane & Beverly Deitering CONTRACTOR: 1413 Hwy 127
897 Southfork Rd MONDAMIN, IA 51557
Blair, NE 68008
7;
NATURE OF WORK PROPOSED USE
Remodel Primary Residence
PROJECT NAME PERMIT EXPIRES 02/02/2014
897 So uthfo rkRd- 120203- Remode l
ESTIMATED COMPLETION DATE 2012 -04 -01
DESCRIPTION OF WORK
Basement Remodel. Will have finished bathroom and bedroom /gameroom. Closing in water meter and gas furnace
and water heater.
i
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
I
i
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
appli agon.
ign tare of Appli ant ` Date
I
I
�I