RE-2013-00385.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRAS" 68008
1�a v wilding Permit Application (402) 426 -4191 - Phone
A' (402) 426 -4195 - FAX
RE- 2013 -00385
h Q www.blairnebraska.org
09/05/2013 bpeterse REMODEL Commercial September 9, 2013
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Im LOCATIONOFIMPROVEMENT:
A 108 S 12th St, Blair, NE 68008
r ARCHITECT:
_ GENERAL SELF
OWNER: Mitchell Co Paxton CONTRACTOR:
108 S 12th St Blair, NE 68008
BLAIR NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Remodel Primary Commercial
PROJECT NAME PERMIT EXPIRES 09/09/2015
108S12thSt- 130905 - Repair to roof of building ESTIMATED COMPLETION DATE 12/31/2013
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DESCRIPTION OF WORK
Repairing roof and partial wall of building that had some collapse due to storm damage.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED: Received
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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 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
lic 'on.
nature of pplicant a✓ Esc j 1 Xc - 11-ae ccv to
CITY Of BLAIQ
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BUILDING PERMIT SUPPORTING DOCUMENTS
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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.
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I 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.
Owner /Occupant ntractor x ¢,, J , x e -.kf
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City of Blair
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218 South 16th Street • Blalr, Nebraska 68008 • 402 -426 -4191 • Fax 402 - 426 -4195 E -mall cltyofblalr @d,blalr.ne.us j