ME201200473APPLICATION.TIF CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
r Building Permit Application (402)426 - 4191 -Phone
(402) 426 -4195 - FAX
ME - 2012 -00473 ;se 01 a� www.blairnebraska.org
10/18/2012 MECHANIC Residential October 18, 2012
LOCATIONOFIMPROVEMENT: 1909 Soren Dr, Blair, NE 68008
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r ARCHITECT: GENERAL Standard Htg & A/C Inc
r OWNER: Jcm Investments Inc CONTRACTOR: 11746 Portal Rd
7110 Morgan Cir Omaha, NE 68128
OMAHA, NE 68152 -0000
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NATURE OF WORD PROPOSED USE
Sub -Work New Const Primary Residence
PROJECT NAME PERMIT EXPIRES 1011812014
1909SorenDr 120827 -New Residential ESTIMATED COMPLETION DATE 11/18/2012
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DESCRIPTION OF WORK
1 100,000 BTU Furnace, 14 Ton A/C Unit, Duck work, vents
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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 he codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with or with t the`fntention of the undersigned or any alteration or change from this application without approval of the
Building Official, hall co titute s fficient ground for the revocation of any permit issued which was based on the approval of this
application.
/ O � Signature of Applicant Date