MS-2013-00378-1.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
B uilding Permit Application (402) 426 -4191 -Phone
A (402) 426 -4195 - FAX
MS -2013 -00378 rO "Y'le of www.blairnebraska.org
09/03/2013 MISC Residential September 3, 2013
M 0 LOCATIONOFIMPROVEMENT: 1063 N 17th Ave, Blair, NE 68008
ARCHITECT:
� GENERAL SELF
OWNER: Brian K Sandall CONTRACTOR:
1063 N 17th Ave
Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Fence primary
PROJECT NAME PERMIT EXPIRES 09/03/2015
1063 N 1 7th Ave - 130903 -Fence
ESTIMATED COMPLETION DATE 12/31/2013
DESCRIPTION OF WORK
6' board on board cedar fence replacing existing fence on property line
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Brian Sandall
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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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 accordanc wit . he codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with w t t th intention of the undersigned or any alteration or change from this application without approval of the
Buildin Offic *a , hall onstitute suff ground for the revocation of any permit issued which was based on the pproval of this
ap i tion.
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ROOF PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and /o ermit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2009 International Building
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your roofing permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
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have read th above disclosure and accept this building permit documentation on my
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own b alf Lyning f I responsibility as the owner /contractor for this project.
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Owner/ ccupant Contractor
City of Blair Date
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218 South 16th Street ° Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cityofblair @cl.blair.ne.us P.owr�..r.