ME-2013-00423_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
llll lil 1t Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
ME- 2013-00423 A10 ige of www.blairnebraska.org
09/20/2013 bpeterse MECHANIC Residential September 20, 2013
LOCATION OF IMPROVEMENT: 652 S 16th St, Blair, NE 68008
ARCHITECT: GENERAL Holly Heating
s
OWNER: Paul S Smith CONTRACTOR: 11107 Bridgeview Dr
. 652 S 16th St Blair, NE 68008
BLAIR, NE 68008 -0000
a
NATURE OF WORK PROPOSED USE
Elect /Mech /Plumbing Primary Residence
PROJECT NAME PERMIT EXPIRES 09/2012015
652S16thSt- 130920 - Mechanical 9/30/2013
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
100,000 BTU Furnace, 2.5 ton A/C and tankless water heater.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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
application
F�
Date
Signature of Applicant_ j