AD-2012-00290_0001 (3).tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
AD 2012 -00290 (402) 426 -4195 - FAX
7s° 01 Q' www.blairnebraska.org
07/24/2012 ADDITION Residential July 26, 2012
LOCATIONOFIMPROVEMENT: 12686 Co Rd 27, Blair, NE 68008
ARCHITECT:
lr= GENERAL Warrick Construction Co.
OWNER: Kari & Kurt Loseke CONTRACTOR:
1114 James Dr
12686 Co Rd 27 Blair, NE 68008
Blair, NE 68008
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NATURE OF WORK PROPOSED USE
Addition Primary Residence
PROJECT NAME PERMIT EXPIRES 07/24/2014
12686Co Rd 27- 120724 - Addition
ESTIMATED COMPLETION DATE 11/30/2012
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DESCRIPTION OF WORK
21' x 14' addition onto the back of the house to be used for a larger master bedroom and master bathroom. Also
adding a concrete patio to the outside off of the new addition.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
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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
Building qfficial, shall )con titute sufficient gr and for the revocation of any permit issued which was based on the approval of this
p licatio
i nature of Applicant Date