PL-2013-00192_0001.tif 7
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
x (402) 426 -4191 - Phone
Building Permit Application
(402) 426 -4195 - FAX
PL -2013 - 'n/se of q0' www.blairnebraska.org
N i ii ; 1
06/06/2013 bpaterse PLUMBING Residential June 6, 2013
LOCATIONOFIMPROVEMENT: 501 S 25th St, Blair, NE 68008
ARCHITECT:
GENERAL SELF
�f OWNER: Dennis P And Carol Penry CONTRACTOR:
501 S 25th St Blair, NE 68008
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BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Sub -Work New Const Primary Residence
PROJECT NAME
PERMIT EXPIRES 06/06/2015
501 S 25thSt- 130423 - Addition 6/6/2015
ESTIMATED COMPLETION DATE
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DESCRIPTION OF WORK
Plumbing for kitchen and bathroom area addition.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck /COMcheckSUBMITTED: 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 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
fa t- with or without the intention of the undersigned or any alteration or change from this application without approval of the
ilc ing Offi ' I, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a / p((icatio
Akure of Applicant Date