AD-2012-00166_0001.tif CITY OF BLAIR
{ 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
lllldillg Permit Application
(402)426- 4191 -Phone
(402) 426 -4195 - FAX
AD -2012- 00166 n% of Q�Q�� www.blairnebraska.org
05/04/2012 ADDITION Residential May 15, 2
< LOCATIONOFIMPROVEMENT: 2018 Grant St, Blair, NE 68008
ARCHITECT:
GENERAL DW Contracting
.�.= OWNER: David M And Jeene M Hobbs Brehm CONTRACTOR: PO Box 641622 �
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2016 Grant St OMAHA, NE 68164
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 05/04/2014
2018GrantSt- 120504 - Residential Addition
ESTIMATED COMPLETION DATE 8/31/2012
DESCRIPTION OF WORK
New bedroom and family room addition to be added onto house.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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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
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 Ahe undersigned or any alteration or change from this application without approval of the
Buildin ficial shall constit s icient round fqL the revocation of any permit issued which was based on the approval of this
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