AC-2014-00076.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
UIIC$IIl Permit IIatl11 (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
AC 2014 -00076 ° hise of qJO� www.blairnebraska.org
03/14/2014 ACCESS Residential March 14, 2014
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LOCATIONOFIMPROVEMENT:
13476 Springridge Loop, Blair, NE
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ARCHITECT:
GENERAL J Nielsen Construction LLC
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f OWNER: J Nielsen Construction LLC CONTRACTOR: 1730 State St
K 1730 State St BLAIR, NE 68008 -1568
s� BLAIR, NE 68008 -1568
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NATURE OF WORK PROPOSED USE
New Construction Accessory Building
PROJECT NAME PERMIT EXPIRES 0311312016
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1347 6 S p ri n g ri d g e Loo p- 140310 -New
Residential ESTIMATED COMPLETION DATE 3/1412016
DESCRIPTION OF WORK
Accessory Building will have electric.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheckSUBMITTED: 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 sufficit ground for the revocation of any permit issued which was based on the approval of this
application.
Signature of plic nt6ate
CITY OF , NEBRASKA
Phone 402-4.26-4191
RECEIVED OF:
ADDRESS
CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
NO _
RECEIVED BY
Pounds Printing, Blair, NE 68008
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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.
A wner/(OWdpak Contractor
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City of Blair ate
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218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E-mail cltyofblalr@olblalrne.us oPPOw,n;
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