PL-2012-00442_0001.tif i
w CITY OF BLAIR
' 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
f� s = building PermitApplicati ®n (402)426 - 4191 - Phone
A \\\,r (402) 426 -4195 - FAX
PL- 2012 -00442 � °f quA www.blairnebraska.org
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10109/2012 kbedmins PLUMBING Residential October 9, 2012
LOCATIONOFIMPROVEMENT: 1005 Colfax St, Blair, NE 68008
ARCHITECT: GENERAL CNJ Plumbing Inc
.1 OWNER: Nielsen Homes and Development Inc CONTRACTOR: 1665 State St
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1730 State St Blair, NE 68008
s BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Sub -Work New Const Primary Residence
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PROJECT NAME PERMIT EXPIRES 10109/2014
1005ColfaxSt- 121009 - Plumbing ESTIMATED COMPLETION DATE 1019/2014
DESCRIPTION OF WORK
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PLumbing for New Construction
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Pending
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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F a ate ?,.
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 II constitu sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
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Signature of Applicant
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