CN-2013-00566 (2).tif CITYOFBLAIR j
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
CN- 2013 -00566 A '��, ;Se o , www.blairnebraska.org
12116/2013 COM -NEW Industrial January 8, 2014
LOCATIONOFIMPROVEMENT: 10249 Cook Dr, Blair, NE 68008
® ARCHITECT:
® GENERAL T. Hurt Construction, Inc.
® OWNER: Skn Development Corp CONTRACTOR: 8398 Dutch Hall Rd
PO Box 488 Omaha, NE 68122
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
New Construction Primary Commercial Structure
PROJECT NAME PERMIT EXPIRES 07/06/2014
10249 Cook Dr- 131216- Repair Garage ESTIMATED COMPLETION DATE 9/1/2014
DESCRIPTION OF WORK
80 x 50 Repair Garage. Will have electrical, HVAC and plumbing.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: Pending
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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 Insp for is issued.
5. The undersigned owne or agent agree perform the proposed work in accordance with the specifications set forth above and
in accor/w" odes /ord' a e of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact wit in nti f e er igned or any alteration or change from this application without approval of the
Building sti cient ground for the revocation of any permit issued which was based on the approval of this
applica i
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Date
Signature of App scant
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CITY OF phone 402 -420 -4191
RECEIVED OF:
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CITY. STATE' ZIP CODE
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KEEP THIS COPY FOR YOUR RECOF
THANKYOU
NO RECEIVED BY
Pounds Printing, NE 68008
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Promise
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BUILDING PERMIT DEPOSIT AGREEMENT
$500 00 r undable deposit is being collected for any new commercial, new
rest en ial, 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.
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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. j
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 completed without a final inspection being done.
6) 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
all of the above situations occur, the building permit deposit SHALL be forfeited or
discounted upon the discref n of the City of Blair, Building and Inspections
Department.
4 ntra(5to Contractor /Owner
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Ci ty of Blair
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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.
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I have read the above disclosure and accept this building permit documentation on my j
own behalf assuming full responsibility as the owner /contractor for this pr 'ect.
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Owner /Occupant ont r
City of Blair ate
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218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 E-mail cityofblair @ci,blair,ne.us � •