PB-2013-00233.tif CITY OF BLAIR j
218 S. 16TH STREET
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BLAIR, NEBRASKA 68008
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_ = Building Permit Application (402) 426 -4191- Phone
PB -2013 -00233 �� (402) 426 -4195 -FAX
° ° rise o; a�`� www.blairnebraska.org
06/26/2013 POLEBARN Residential October 18, 2013
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LOCATIONOFIMPROVEMENT: 9160 Co Rd P33, Blair, NE 68008
ARCHITECT: GENERAL SELF
OWNER: Todd L And Traci R Hipnar CONTRACTOR:
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439 N 19th St Blair, NE 68008
BLAIR, NE 68008 -1505
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NATURE OF WORK - PROPOSED USE
New Construction Pole Barn
PROJECT NAME
PERMIT EXPIRES 06/26/2015
916OCo Rd P33 - 130626 -New Residential
ESTIMATED COMPLETION DATE 3115/2014
DESCRIPTION OF WORK
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100'x 60° Pole barn.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Pending
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 ed on the approval of this
plication .
gnature of ate
Applicant
CITY OF BLAIR, NEBRASKA
Phone 402 - 426 -4191 j
RECEIVED OF:
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ADDRESS
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CITY, STATE, ZIP CODE.
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THANKYOU KEEP THIS COPY FOR YOUR RECOR
RECEIVED BY
Pounds Printing, Blair, NE 68008
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" C Of I)LAIQ
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BUILDING PERMIT SUPPORTING DOCUMENTS
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 International Building
Code requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in your building permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the owner /contractor for this project.
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(42 Contractor
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City of Blair Date
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218 South 16th Street • 81a1r, Nebraska 68008 • 402 - 426.4191 • Fax 402 - 426 -4195 E -mall cllyofblalr @c1.blalr.ne.us
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