CN-2014-00666.tif ' F AX No 402 932 6660 P,002
AUG /Q4 /2014 /N�QN 07:10 AM McDonald s�LMI .
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DITYOFBMR
218 S. 9 6TH STREET
BLAIR, Nt=8RASKA 58008
Building Permit Application (402) 426.4999 - Phone
u (402) 426 -4996 - FAX
ON- 20147 00666 ,Fa %,t s ac F14 www.blairnabraska.org
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0612712014 COM -NEW commercial July 30, 2t�14
LOCATICINOPIMPROVEMENT 920 Washington St, Blair, NE 68008
ARCHTECT: GENERAL Tuff Shad Inc,
OWNER. Llc Mcdonalds Carp Archland Property I CONTRACTOR:
7530 L St
•202 9408 Vetrans Drste Omaha, NE 68127
ELKHORN, NE 68022 - 0000
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NATURE OF WORK STRUCTURE
New Construction
Accessory Structure
PROJECT NAME PERMIT EXPIRES 06/26/2016
929WashingtonSt- 940627 Accessory ESTIM COMPLETION DA TE 9/ 112014
Structurs
DESCRIPTION OF WORK
10 x 16 Accessory Building for Storage
DEPOSIT PAID BY: SITF PLAN SUBMITTED: Received
Contractor
RESchenk[COMcheck SUBMITTED: NA
DEPOSIT STATU& BUILDING PLANS SUBMITTED: Received
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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, ventliating and air conditioning, and septio system.
4. The undersigned owner or agent understand$ 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
pp[ica� II
S a #urg of Appli¢att£ e
AUG /04/2014/MON 07;10 APB Mdornald's /LMI FAX No, 402 932 6680 P.003
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CITY O f AID.
iso of �+
BUILDING PFERMIT S UPPORTING DOCUMENTS
This building permit packet includes various items dealing with particular code
requirements and /or building permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility 'to know the 2049 International Building
Code requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in your building permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
1 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.
wrlerl - ccupant Contractor
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City of Blair Tate
218 South 16th S eet • 6lak, Nebraska 68008 - 402 -426 -4191 - Fax 402 - 4264195 [--mall Qltvo1Na1r@ol.b1alrne.us • '
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AUG /04/2014/MON 07;10 API McDonald's/LMI FAX No, 402 902 6680 P.004
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BUILDING PERMIT DEPOSIT AGREEMENT
A $500.00 refundable deposit is being collected for any now commercial, new
residential, and any additions, remodels and accessory building valued $10,000 or
greater at the tirne of your building permit application.
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A $200.00 refundable deposit is being collected for any residential remodel,
addition or accesspry building valued under $10,000.
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 fallowing
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.
0) 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.
B) 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 CW of Blair, Building and Inspections
Department.
Contractor /Owner Contractor /Owner
City of Blair
Date
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