ME-2013-00210.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
MAKA _0 Building Permit Application
(402) 426 -4191 -Phone
(402) 426 -4195 - FAX
ME- 2013 -00210 /Se °, q � ° www.blairnebraska.org
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0611812013 bpeterse MECHANIC Residential June 20, 2013
LOCATIONOFIMPROVEMENT: 501 S 25th St, Blair, NE 68008
ARCHITECT:
®, GENERAL Holly Heating
`K OWNER: Dennis P And Carol Penry CONTRACTOR: 11107 Bridgeview Dr
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501 S 25th St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Sub -Work New Const Primary Residence
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PROJECT NAME PERMIT EXPIRES 06/2012015
501 S25thSt- 130423 - Addition 6/18/2015
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
New 80,000 BTU furnace and 2.5 ton A/C replacement.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheckSUBMITTED: NA
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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
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
,,app lication.
Date
Signature of Appli
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