DR-2012-00315_0001 (2).tif CITY OF BLAIR
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218 SE 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426-4191 -Phone
(402) 426 -4196 - FAX
DR-2012-00315 ° arse www.blaimebrasks.org
08/0212012 DECKRAMP Residential August 10, 2012
LOCATIONOFIMPROVEMENT: 2868 Ravae Ln, Blair, NE 68008
ARCHITECT: GENERAL SELF
OWNER: David D And Lynne C Jackson Allen CONTRACTOR:
2712 Iowa St Blair, NE 68008
OMAHA, NE 68112-0000
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NATURE OF WORK PROPOSED USE
Deck Primary Residence
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PROJECT NAME PERMIT EXPIRES 0890212014
2868RavaeLn- 111018 -New Residential
ESTIMATED COMPLETION DATE 1091!2012
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DESCRIPTION OF WORK j
10 x 16 deck addition onto the back of the 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 the undersigned or any alteration or change from this application without approval of the
ilding Official, shall constitute sufficient ground for the revocation of any permit issued which wasA*s4,d on the approval of this
ap lication.
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Signature of Applicant ` Date