TSI_0001.tif CITY OF BLAIR
218 S, 18TH STREET
BLAIR, NEBRASKA 68008
i _ Building PermitA App lication (402 )426- 4191 -phone
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� ._ � � (4n2) 426 - FAx
PL- 20'12.00539 -0` �'htse ns av o``�' d www.blairnebraska.
Shell J PLUMBING
Commercial Novem 19, 2012
'! 1/19/2 Y -
LDCATIONOFIMP 1520 Nebraska St, Blair, NE 68908
+ ARCHITECT: GENERAL TSI Mechanical
ff CONTRACTOR: 12251 Cary Ste #150 Cir
OWNER: Of Blair City
218 S 16th St La Vista, NE 68128
t < t
s' BLAIR, NE 68008 -0000
57 7777777777'?,'i 7777
NATURE OF WORK PROPOSED USE
Depot Structure in City park
Sub -Work New Const
PERMIT EXPIRES 11/19/2014
PROJECT NAME
15 20NebraskaSt- 121025 -1 ESTIMATED COMPLETION DATE 11/19/2012
DESCRIPTION OF WORK
Groundwork, 1 -water fountain
I
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
NIA
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 ermit signed by the Building Inspector is issued.
proposed worm in accordance with the specifications set forth above and
5. The un rsigned owner or agent agrees to perform the
in acc dance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact ith or without the intention of the undersigned or any alteration or change from this application without approval of the
Bui ing cial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a lic'
Date
Si atur ant