ME201200471APPLICATION.TIF i
I
CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426 - 4191 -Phone
® (402) 426 -4195 - FAX
'�n, of a � www.blairnebraska.org
01 2 kbedmins MECHANIC Residential October 19, 2012
I
LOCATIONOFIMPROVEMENT: 255 N 22nd St, Blair, NE 68008
i
ARCHITECT:
� GENERAL SOS Heating &Cooling
OWNER: William Morehouse CONTRACTOR: 8314 Maple St
7718 N 39th St Omaha, NE 68134
OMAHA, NE 68112 -0415
u
,.,,...0 .�, y- iA:,'e"A'•, `', -- '.:, :� ;,' a , „ „^...r' .;acs .,a- _,.µ. v,:,.`'',.,, -r-. =s .."`''x.°"
P W � x u
NATURE OF WORK PROPOSED USE
Sub -Work New Const Primary residence
PROJECT NAME PERMIT EXPIRES 1 011 912 01 4
255N22ndSt- 111013 - Property Maintenance ESTIMATED COMPLETION DATE 1011812012
DESCRIPTION OF WORK
Installing 90,000 BTU Furnace
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
�. a
MEMBRANE
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, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
pplicatio
-/0A
( Date
Signature of Applicant