AD-2012-00177_0001.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
� + Building Permit Applica tion (402 ) 426 - 4191 -Phone
9u =�� (402) 426 -4195- FAX
AD - 2012 - 00177 ose °f www.blairnebraska.org
05114/2012 ADDITION Residential May 14, 2012
LOCATIONOFIMPROVEMENT: 6 Park St Blair NE 68008
110 ,
ARCHITECT:
® GENERAL SELF
OWNER: Robert D And Peggy Frahm CONTRACTOR:
1133 Park St Blair, NE 68008
BLAIR, NE 68008 -0000
FM
gg
0 - Aw
y
NATURE OF WORK PROPOSED USE
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 05114/2014
1106ParkSt- 120514 - Addition ESTIMATED COMPLETION DATE 1213112012
DESCRIPTION OF WORK
38'x 15' Addition
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COMcheck SUBMITTED: Pending
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Pending
WON
i
M
s, `. ! o .'
1. No work will be started before a ermit is ISSUED AND POSTED w- R
fl
p
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 §4fficient ground for the revocation of any permit issued which was based on the approval of this
r
Ica to f
"Date
ignature of Applicant