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CITYOF BLAIR
218 S. 16TH STREET
' BLAIR, NEBRASKA 68008
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w x g Permit pp
atl O h (402) 426 -4191 - Phone
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n i C (402) 426 -4195 -FAX
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www.blairnebraska.org
MS- 2014 -00398 a ' O o)ls e o f a1
06/18/2014 MISC
Residential June 18, 2014
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LOCATION OF IMPROVEMENT: 1002 South St, Blair, NE 6800
ARCHITECT: GENERAL SELF
OWNER: Keith And Julie Miller Klinger
CONTRACTOR:
y 1002 South St
Blair, NE 68008
BLAIR, NE 68008 -0000
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PROPOSED USE
NATURE OF WORK primary Residence
Storm Repair
PERMIT EXPIRES 06/17/2016
PROJECT NAME
1002SouthSt- 140618 -2014 Storm Damage ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
cement board siding and some windows on north and west sides.
Re p lacing vinyl siding with fiber
DEPOSIT PAID BY:
SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
E:=
ue
1. No work will be started before a permit is ISSUED AND POSTED.
ermits a set of plans for this project must be submitted to the Nebraska State Office for review.
2. For commercial p , and septic c syst
3. Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and does not constitute issuance of m.
4. The undersigned owner or agent understands and acknowledges this building permit appl
shall not be commenced until a
-- this building permit. It is further understood that construction covered by this permit app
copy of a permit signed by the Building Inspector is issued.
or a gent agrees to perform the proposed work in accordance with the specifica of or misrepresentation n
g
5. The undersigned owner g of
in accordance with the codes /ordinances of the City of Blair and the State of Nebraska. Any omission
without approval of the
fact with or without the inten, ` n of the undersigned or any alteratio any c
sued which wa b on the approval of this
Building i -'al, shall con �� �Ye sufficient ground for the revocation o y p
applica" �
Date
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A Pr m ° BUILDING PERM IT DEPOSIT AGREEMENT
osit is being co mercial, new
500.00 refundable dep collected for any new com
access
building valued $10,000 or
A$ d �
residential, and any additions, remodels and a ry
re permit application.
greater at the time of your building p el
is being collected for any residential remod ,
A $200.00 refundable deposit valued under $10,000.
addition or accessory building
A $50.00 refundable deposit is being collected for all misc. permits.
not refund this deposit if any of the following
The City reserves the right to
truction period:
conditions occur during the con owner or general contractor.
1) Theft of water service be obtained.
2) All permits have not be
II ctions have not been obtained.
3) A required inspe
4 Occupancy occurs priinspection.
or to a final inspe
done.
5) The project is completed without a final inspection being If Required)
Ma Pla
If any or all of these situations inspection not obtain forfeit your
6) Storm Water M cations occur during construction, you may
deposit.
above conditions, and understand that should any or
I hereby agree to the cur the building permit deposit SHALL be forfeited
all of the above situations ac Inspections
discounted upon the discretion of the City of Blair, Building and Insp
Department.
f
% ract wry r
Contractor /Owner
City of Blair
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rry
Of t)LAIQ
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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 Cod
requirements that apply to your project. Please understand this document is on e y
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.
J
O er /Occ p n�
Contractor
City of Blair Date
EGUAINOUSINO