MS-2013-00409.tif ,. CITY017BLAIR
f 218 S. € 6TH STREET
BLAIR,NEBRASKA68008
Building Pell i - Phone
(402) 426-4196 - FAX
MS - 2013 - 0 0409 }� U :' .blairnebraska,arg
( 0 1116 01313 bpeterse 1y11SS Residential September 1 5, 2{113
097116127013
I LOCATIONOFIMAROVEMENT. 214 E Baronage Dr. Blair, NE 6300
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ARCHITECT
C7: I GENERAL Outdoor Living LLC
OMER Timothy N And Amy M Murray CONTRACTOR: 91168 97th St
214 E Baronage D � LA VISTA, NE 66126
LAIR, NE 66006 -0000 i
NA TURE ILI
PROPOSED U
i I Primary Residence
7 ;SwirS'$6'1'Si X01 �
PERM EXPIRES 0911612015
PROJECT NAME
214EBaronageDr-130916-Swimming Pool 1
E COMPLE DATE 1111612013
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D ESCRIPTION OF WORK
New 16' x 36$ in ground s wimming pool.
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DE POSIT PAID Y: SITE PLAN SUBMITTED Received
Contractor i
REScheck/C Mcheck SUBW T : NA
DEPOSIT STATUS: � BUILDING PLANS SUBMITTED: Received
$50 I
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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 vlarshal's Office for review.
3. Separate hermits 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
t. .a�w- a......, .a �.ha s.., bo- 4, � is 0 —niiv i,„ ,nn ,�hnii not h,e i tj 3intiI A
this building pern3it. l3 3� Hil8131�1 135 (LdC2.9tL L3U it lLit Vn vvvv. °d b th— p..n nd app at
copy of a permit signed by the Building Inspector is issued_
. The undersigned owner or agent agrees to perform the proposed work in :accordance with the specifications set Barth above and
in accordance with the codeslordinances 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.
Date
Signature of Appiacant
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B UILDING PERMIT DEPOSIT AGREEMENT
$500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or �
greater at the time of your building permit application. 1
$200.00 refundable deposit is being collected for any residential remodel,
addition or accessory building valued under $10,000,
A $50.00 refundable deposit is being collected for all misc. permits..
The City reserves the right to not refund this deposit if any of the following �
conditions occur during the construction period: f
) Theft of water service by the plumber, owner or general contractor.
) All permits have not been obtained.
3) 11 required inspections ;gave im been obtained.
4) Occupancy occurs prior to a final inspection.
) The project is completed without a final inspection being done.
) Storm Water Management Plan inspection not obtained. (if required) �
If any or all of these situations occur during construction, you May forfeit your
deposit.
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I hereby agree to the above conditions, and understand that should any or
all of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discretion of the City of Blair, wilding and inspections
Department,
Contractor /Owner Contractor /Owner
City of Blair -
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BU ILDING PERMIT SUPPORTING DOCUMENT
This building permit packet includes various items dealing with particular code
requirements and /or building permit requirements. It in no way includes ALL particular
code items, Also, it is your responsibility 'to know the 2009 Sri ernati nal ildir
Cody requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in Your building permits process. A copy of the
International Building Code is available for your use at the Flair Public library,
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1 have read the above disclosure and accept this building permit documentation on my j
own behalf assuming full responsibility as the owner/contractor for this project.
r.
Owner/ Occupant Contractor
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jty of Blair Date
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mron{�um
218 Soutli 16th Street Blair, Nebraska 68008 4 402 -426 -4191 8 Fax 402.426.4195 A [-mail cHVotblalr @cl.blalr,ne.us
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