Permit Application (2) i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
°Y Building Permit Application (402) 426 -4191 -Phone
a .,����a (402) 426 -4195 - FAX
MS- 2014 -00398 '�niseof arc www.blairnebraska.org
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06/18/2014 MISC Residential June 18, 2014 r
LOCATION OF IMPROVEMENT: 1002 South St, Blair, NE 68008
r ARCHITECT: GENERAL SELF
s � :OWNER: Keith And Julie Miller Klinger
CONTRACTOR:
1002 South St Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/17/2016
1002SouthSt- 140618 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Replacing vinyl siding with fiber cement board siding and some windows on north and west sides.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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1. No work will be started before a permit is ISSUED AND POSTED. j
0 P^r r`nmmcrt-ml ncrmite n eAt of nlnnc fr,r thic nrniPCt mi mf hp suhmitted to the Nebraska State Fire Marshal's Office for review.
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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 j
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.
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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 following
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.
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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.
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PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and /or 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 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 permit documentation on my own
behalf assuming full responsibility as the owner /contractor for this project.
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,�O er /Occ p nt Contractor