SP-2014-00074.tif 03114/2014 09:00AM 4028964477 CPS WRHSE PAGE 02/03
CITYOFBLAIR
218 S. 16TH STREET
` BLAIR, NERRASKA68008
Building Permit Application (402) 426 -41 Phone
�p_01 -�Q�� f � (402) 426 -4195 - FAX
hose of a www.blaimebraska,org
i
)$/12/2014 SWIMPOOL Residential March 13, 2014
LOCATIONOFIMPROVEMENT: 13647 Spring Loop Blair, NE 6uooa
ARQHITE .
e GENERAL Classic Pool & Spa
a
0WNER: Timothy J And Ta mera S Memanigal CWtRA=R 4213 S 120th St
269 N 23rd St OMAHA, NE 68137
BLAIR, NE 68008 -0000
I MIN
w a •
NA TURE OF WORK PROPOSED USE
Swimming Pool Swimming Pool
PROJECT NAME PERMIT EXPIRES d'�Jii/20iC
13647Sprin gridgeLoop- 130912 -New►
Residential ESTIMATED COMPLETION DATE 3/12/2016
i
DESCRIPTION OF WORK
In ground swimming pool in backyard.
I
DEPOSIT PAID BY: SITE PLAN SUBMIT T90: Received
Contractor
REScheck/COMcheck SUBMITTED: NA
DE POSIT STATUS: BUILDING PLANS SUBMITTED. Received
9. 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.
t. 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.
�. 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 Oftial, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
gnature a App,ico t Data
CITY OF BLAIR, NEBRASKA
Phone 402 - 420 -4191
RECEIVED OP ,
ADDRESS Fly
I
CITY, STATE, ZIP CODE
i
THANKYOU EP IS 0PYFORYOURRECORDS.
No 35071
ED BY
Pounds Printing, Blair, NE 68008
i
03114/2014 09:00AM 4028964477 CPS WRHSE PAGE 03163
i
I
I
Promise
a
BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any new commercial, new
residential, and any additions, remodels and accessory bullding 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.
The City reserves the right to not refund this deposit if any of the fallowing
conditions occur during the construction period:
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 completed without a final inspection being done.
(3) Storm Water Management Plan inspection not obtained. (If Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
1 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 discretion of the City of Blair, Building and Inspections
Department.
Con orl wner ContractorlOwner —
City of Blair
Date !_