ME-2013-00547.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
v (402) 426 -4191 - Phone
B uilding Permit Application
(402) 426 -4195 - FAX
ME -2013 -00547 is of a www.blairnebraska.org
IN
11/21/2013 bpeterse
NEEMEN IMECHANI C Residential November21,2013
d LOCATIONOFIMPROVEMENT: 765 N 16th St, Blair, NE 68008
I
r ARCHITECT: GENERAL SELF
OWNER: Me an E Smith CONTRACTOR:
Megan
r 765 N 16th St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Elect /Mech /Plumbing Primary Residence
PROJECT NAME PERMIT EXPIRES 11/21/2015
765N16thSt- 131023- Electrical ESTIMATED COMPLETION DATE 12/21/2013
DESCRIPTION OF WORK
Adding a gas line from furnace room in basement to wall in the garage. 80,000 BTU Furnace for garage.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
N/A
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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
appl' ation.
Date
S nature of Applicant