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MS-2014-00182.tif CITYOFBLAIR J ' 218S.16THSTREET BLAIR, NEBRASKA 68008 . BUIlding P@rmit Application (402) 426 -4191 - Phone (402) 426 -4195 - FAX a '��;se os q o www.blairnebraska.org MISC Residential April 24, 2014 LOCATIONOFIMPROVEMENT: 755 N 10th Ave, Blair, NE 68008 IFRM ARCHITECT. GENERAL F/S Contracting a OWNER: Aigars And Terrie A Deklays CONTRACTOR: 324 S 13th St v rf 755 N 10th Ave Tekamah ' NE 68061 ✓��fr I y BLAIR, NE 68008 -0000 / ✓rJf> jar fir' Ir x �1 NATURE OF WORK PROPOSED USE Roofing /Soffit/Eaves /Gutters Primary Residence PROJECT NAME PERMIT EXPIRES 04/23/2016 755N10thAve- 140424 -Roof ESTIMATED COMPLETION DATE 4/2412014 i DESCRIPTION OF WORK Replacing roof with asphalt shingles. DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA Contractor REScheck /COMcheck SUBMITTED: NA DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA FAIN MM 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 plic do _ n A4 icant Date i OF3 �5 Ph ©e4fl -41 RECELY D�bF � �� r s ADDR SS CIW 9 VtTEZIPEDQE ' � s r M ift �u y Was - s r mwm x fl MEMO 0 "OST - non Amon r s f � } Y i ma note RAMAT f � I 1 l F n_ ##. } m E s z j a L - t fRA x F n a h: THAfdKY0 7 iS T�iS ©P'C flF 'F?� t E Ce D -gy Pao Vo _ ' ' FtE'biEtyED�Y� t rfi Pounds Printing; Bta,K N6B800B ti - " `� z 3 I t I i TV Of I)LAIQ ° /ise of a� ROOF PERMIT SUPPORTING DOCUMENTS This supporting document includes information dealing with particular code requirements and /or roofing 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 document is only designed and distributed to aid you in your roofing 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 owner /contractor for this project. i er /Occupant o City of Blair tD e ova 218 South 16th Street • Blair, Nebraska 68008 • 402- 426 -4191 • Fax 402 -426 -4195 E -mail cl1yofblalr@cl.blalrne.us i i I If I ' � *r d O p BUILDING PERMIT DEPOSIT AGREEMENT A $500.00 refundable deposit is being collected for any new commercial, new residential, 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. $50.00 fundable deposit is being collected for all misc. permits. ity reserves the right to not refund this deposit if any of the following i 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. 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 discretion of the City of Blair, Building and Inspections Department. i An Contractor /Owner I i City of Blair ate