AC-2014-002322.tif I
CITYOFBLAIR
'. 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
ep+ - Building Permit Application (402) 426 -4191 -Phone
9 � (402) 426 -4195 - FAX
AC -2014 -00232 rose o , Go www.blairnebraska.org
05/16/2014 ACCESS Residential May 19, 2014
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LOCATIONOFIMPp EMENT; 231 E Riverview Dr, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: Mgt�P "And Angela M Hodson CONTRACTOR:
231•,F Riverview Dr Blair, NE 68008
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NATURE OF WORK
PROPOSED USE
New Constructi6n"T�' Garden Shed
PROJECT NAME
PERMIT EXPIRES 05/15/2016
231ERiverviewDr 140516- Garden Shed ESTIMATED COMPLETION DATE 9/1/2014
DESCRIPTION, ±�IIIORK
12 x 14 garden shQr ®n a floating slab. Slab will be 3 wider than all exterior walls.
DEPOSIT PAID BY, 3 " 5 ' SITE PLAN SUBMITTED: Pending
Contractor s :,
REScheck /COMcheckSUBMITTED: NA
DEPOSIT STATUS BUILDING PLANS SUBMITTED: Pending
1. No work will be started, before a permit is ISSUED AND POSTED.
2. For commercial pouNts, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
3. Separate permits,' t,, Cequired 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 permi €,' 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 withob) intention of the undersigned or any alteration or change from this application without approval of the
Building Official, shslk,tonstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
Viganature tion.
� of Ap plicant Date
A
Phone 402-426-4191
RECEIVED OR
ADDRESS
CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS COPY FOR YOUR RECOR
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RECEIVED BY
Pounds Printing, Blair, NE 68008
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BUILDING PERMIT SUPPORTING DOCUMENTS
This ie�uMing permit packet includes various items dealing with particular code
requlrerhents and /or building permit requirements. It in no way includes ALL particular
code, , te1 Also, it is your responsibility 'to know the 2009 International Building
Code requirements that apply to your project. Please understand this packet is only
des - 0t1ed and distributed to aid you in your building permit process. A copy of the
Interrlatiflnal Building Code is available for your use at the Blair Public Library.
I hay e "read the above disclosure and accept this building permit documentation on my
own bepalf assuming full responsibility as the owner /contractor for this project.
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rt'et /Occupant Contractor
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City lair a
2117 Sauth' Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 -426 -4195 E -mall cityofblair @cl.bla(r,ne.us I
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BUILDING PERMIT DEPOSIT AGREEMENT
x ',$500.00 refundable deposit is being collected for any new commercial, new
,,s dential, and any additions, remodels and accessory building valued $10,000 or
greater at the time of your building permit application.
- -A' "x$200f refundable deposit is being collected for any residential remodel,
:
C cllld "io acc essory building valued under $10,000.
A $50.00 refundable deposit is being collected for all misc. permits.
T City reserves the right to not refund this deposit if any of the following
:nditions 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)
any or all of these situations occur during construction, you may forfeit your
dopPsit.
I hereby agree to the above conditions, and understand that should any or
64:of the above situations occur, the building permit deposit SHALL be forfeited or
d[ gounted upon the discretion of the City of Blair, Building and Inspections
department.
Contractor/Owner Contractor /Owner
City of Blair
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