EL-2014-02147_0001.tif 1
CITYOF BLAIR f
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
" � 1 �) - -. K Building Permit Application (402) 426 -4191 -Phone
(402) 426 -4195 -FAX
EL- 2014 - 02147 f
�� ° '��se os a ° ° �� www.blairnebraska.org
08/13/2014 ShellyJ ELECTRIC Residential August 13, 2014
LOCATIONOFIMPROVEMENT: 1250 Corey Dr, Blair, NE 68008
1 ARCHITECT:
GENERAL SELF
OWNER: Gregory W Mcintosh CONTRACTOR:
1250 Corey Dr Blair, NE 68008
BLAIR, NE 68008 -0000
21 N
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NATURE OF WORK STRUCTURE
Sub -Work New Const Primary
PROJECT NAME PERMIT EXPIRES 08/12/2016
1250CoreyDr- 140624 - Garage addition
ESTIMATED COMPLETION DATE 9/30/2014
DESCRIPTION OF WORK
Electrical for garage addition
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS:
BUILDING PLANS SUBMITTED: NA
N/A
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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
Build' Official, shall constf ute, sufficient ground for the revocation of any permit issued which was based on the approval of this
ap icati n.
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Date
Signature of pplicant
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