MS-2013-00464.tif 2013 - Oct -09 10:06 AM One Stop Shop 402 - 991 -9961 2/3
CITYOFBLAIR
218 8,16TH STREET
BLAIR, NEBRASM68008
B uilding Permit A pplication (402) 42 - 4191 - Ph
° a (402) 426.4199 - FAX
MS- 2013.00464 '�M �, c au www,bleirnabraska,org
10I09i2013 bpeterae MISG Residential October 9, 2013
LOCA110NOVIMPROVEMENM 710 N 18th Ave, Blair, NE 68008
ARCHItECT: GENERAL One Stop Shop, 1-1-0
+ ■ OWNER: quail Run Apartments, Lic CONTRACTOR 3335 N 109th Plaza Ste B
701 Olsen Dr Ste 108 OMAHA, NE 69164
PAPILLION, NE 68046.0000
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NATURE OF WORK PROPOSED USE
Siding Apartment Complex
PROJECT NAME PERMIT EXPIRES 10/09/2015
710 N 18thAve- 131009 -S Id ing
ESTIMATED COMPLETION DATE 10/31/2013
DESCRIPTION OF WORK
Replacing siding on building 0720 -vinyl siding
13EPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck1COMcheck SUBMITTED: NA
DEPOSIT STATUS: 13UILDING PLANTS SUBMITTED- NA
$50
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1. No work will be started before a permit is ISSUED AND POSTED,
a. 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,
6, 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 Offlcial, shall stltute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Date
signature of Applicant
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2013 - Oct -09 10:06 AM One Stop Shop 402 - 991 -9961 3/3
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BUILDiNG PERMIT DEPOSiT AGREEMENT
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A $600.00 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.
A $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:
1) Theft of water service by the plumber, owner or general contractor.
2) All permits have not been obtained.
3) All required inspections have not been obtained.
4) Occupancy occurs prior to a final inspection. j
5) The project Is completed without a final inspection being done,
6) Storm Water Management Plan Inapection not obtained. (If Required)
if any or all of these situations occur during construction, you may forfeit your
deposit.
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, Building and Inspections
Department.
Contractor /Owner Contractor /Owns
City of Blair
c�l� t
Date