BUILDING PERMIT APPLICATION.TIF Nov, B. 2012 11,25AM CITY OF BLAIR (402, 426. 4191) No, 7896 P, 2
CITY OF BLAIR
218 S. 16TH STREET
-- BLAIR, NEBRASKA 68006
Building Permit Applicati (402)426- 4181 -Phone
;ME-2 (402) 426 4195 -FAX
QrO �+r a' www.blairnebraske.org Ins
12 MECHANIC Residential Nov 2012
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LOCATIONOFIMPROVEMENT: 208 Arthur St, Blair, NE 68008
ARCHITECT;
GENERAL A 1 United Heating & Air Conditioning
p OWNER: Diane F And Roland L Foster CONTRACTOR; 4972 F St
4620 Avenue E Omaha, NE 68117
KEARNEY,NE 68847-0000
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NATURE OF WORK PROPOSED USE
Sub -Work New Col Primary Residence
PROJE NAME PERMIT EXPIRES 111061201
208Arthur5t- 120925 -New Residential
ESTIMATED COMPLETION BATE 111e12012
DESCRIPTION OF WORK
70,000 BTU FURNACE, 3 -TON AC. Ductwrok. Vents and fans.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheckfCOMchock 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 most 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 icial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
ar lic- ion.
Signature of Applicant Date