RE-2012-00087_0001.tif = CITY OF BLAIR
° 218 S. 16TH STREET
1 BLAIR, NEBRASKA 68008
Ulldltl rf111t pI1CatB ®11 (402)426- 4191 -Phone
RE 2 ®12m ® ® ®�7 =`; (402) 426- 4195 - FAX
° ,st www.blairnebraska.org
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03/23/2012 REMODEL Residential April 3, 2012
LOCATIONOFIMPROVEMENT: 2612 Larsen Dr, Blair, NE 68008
ARCHITECT:
GENERAL J Nielsen Construction LLC
OVIMER: Theodore N And Vicki L Schrick CONTRACTOR: 1730 State St
2612 Larsen Dr BLAIR, NE 68008 -1568
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Remodel Primary Residence
PROJECT NAME PERMIT EXPIRES 03/23/ 2014
2612LarsenDr- 120323 - Remodel
ESTIMATED COMPLETION DATE 2012 -05 -31
DESCRIPTION OF WORK
Reframing bathroom in basement and changing some fixtures. Dividing rec room in basement also,
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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
application
m
Date
gnature of Apps ant