RN-2013-00356.tif 0911612013 12:46 4028955357 PAGE 01
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CITY01 7BLAIR
219 9, 16Tt1 STREET
Bi.AIR, NEBRASKA 66006
Building Pe rmi t Applicati (402) 42644191 m Phone
a (402) 426 °4995 o FAX
RPJ ®2 013 ®d ®356 �'�Ml,� �; a �� www.blalrnobraske.org
0912 ?12013
ftES -NEW Resldentiai September 9, 2013 p
LOCATIONOFIMPROVEMEW 2052 Wright St, Blair, HP 660013
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® GENERAL Melvin Sttdbeck Homes, Inc.
Melvin Sudbeck Homes, Ina CON�fTRAMR: 16255 Woodland ®r
16255 Woodland Ur Omaha, NE 66435
OMAHA, NE 6013&0000
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MEMO: I NAT OF WORK PROPOSED USE
Now Construction Primary Residence
PERMIT` EXPIRES 0912712046
PROJECT NAME
2062Wright8t °130827 -Now Residential ESTIMATED COMPLETiON DATE 412712014
DESCRIPTION OF WORK
2 bedroom$ 1 bath, 2 car garage with unfinishad basement.
DEPOSIT PAID BY SITE PLAN SUBMITTED, Received
Contractor
E3checidCOMcheek SUBMITTED: Received
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DEPOSIT STATUS: BUILDING PLANS SUBMITTED Received
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IS
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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 pennit. 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 isaoed,
5. The undei�lgn6d owner or agent agrees to perform the proposed work In accordance with the specifications set forth above and.
In accordance with the codeelordinances of the City of Blair and the State of Nebraska, Any omission of or mlerepresentation 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
plication• _ f
nature of Appileant `
09116/2013 12:46 4028955357 PAGE 02
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6 ,x promise
BUILDING PERMIT DEPOSIT AGREEMENT
A $600,00 fundable deposit Is being Collected for any new commercial, new
reside , 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 a=s�Pry building valued under $10,000,
A $60,00 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 periods
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.
5) The project is complet Without a final inspection being done.
0) Storm Water Management Plan inspection 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 1 i
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.
ontraotor /Owner Contractor /Owner
City of Blair
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09/1612013 12:46 4029955357 PAGE 03
CITY Of b Ao of
BUILDING PERMIT SUPPC1FtTING 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 B0 ding
2a a 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.
I have read the above disclosure and accept this building permit documentation on my
own behalf assuming full responsibility as the ownerlcontractor for this project.
Owned0ccupant o rector
city of Blair to
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218 With 16th Street ° Wa1r, Nel=ska 68908 ^ 402.426 -419 ° rax 402 - 476.4195 ^ E-matl cllyclblalr ®ci.b ne.uo
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