PL-2012-00467_0001.tif i
Oct 19 12 09:19a Northern Plumbing 402 963 9144 p.2
CITY OF BLAIR
21a S. 16TH STREET
BLAIR, NEBRASKA 68008
(402 )426-4191 -Phone
_ Building Permit Application (402)4264115 -FAx
' www.blalrnebraska.org
PL- 2012 - 00467
IEEE NONE nomm�
1 011 712 01 2
PLUMBING Residential October 17, 2012
LOCATIOhIOFIMPROVEMENT: 1909 Soren Dr, Blair, NE 68008
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ARCHITE=CT: CENERAL Northern ontractors, Inc.
e CONTRACTOR: 16121 Lai a St
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CMT ER: Jcrn investments Inc 68116
7110 Morgan Cir Omaha,
OMAHA, NE 68152 -0000
0
a 7 ary • 7NATUR OF WORK OSED EASE
Structure
rmit
P ERMIT EXPIRES 1011712014
PROJECT NAME
1909SorenDr- 120827 -New Residential ESTIMATED COMPLEPt N DATE 9110/2014
DESCRIPTION OF WORK
4 bedroom 2 story with 3 baths, unfinished basement with 314 rough In in basome . 3 car garage.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
FI:EScheck/C0McheckSUBM1TTE NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 conditio iing, and septic system.
4. The undersigned owner or agent understands and acknowledges this building permit a p6cation does not constitu #e issuance of
this building permit. It is farther understood that construction covered by this permit a plication 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 ith the specifications set to
above and
in accordance with the codeslordinances 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 fror i this application without approval of the
Building Official, shall constitute sufficient ground for the revocation of any permit issue which was based on the approval of this
application 5�CY2
N r I V� (s1Y7'f cQ (,� Ors Date i
Si nature of Applicant