MS-2014-02354.tif I
CITYOF BLAIR
218 S. 16TH STREET
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BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS- 2014 -02354 �M;sa as ago www.blairnebraska.org
08/21/2014 MISC Commercial August 21, 2014
LOCATIONOFIMPROVEMENT: 1822 Washington St, Blair, NE 68008
� ARCHITECT:
GENERAL Les Johnsen Construction LLC
OWNER: Lincoln Federal Savings Bank CONTRACTOR:
2353 Nebraska St Apt 6
PO Box 545 Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Fence Primary Residence
PROJECT NAME PERMIT EXPIRES 08/20/2016
1822WashingtonSt- 140821 -Fence 8/30/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
4' PVC fence to surround AC unit. j
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: 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.
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 Mtep� ion of the undersigned or any alteration or change from this application without approval of the
Building Off ial, shallconstit6te sufficient ground for the revocation of any permit issued which was based on the approval of this
applicatiQrf
Signature of Ap licant Date
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CIT Pholle 4()2-426-4191
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RECEIVED OF: ,
ADDRESS j
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CITY, STPTE, ZIP CODE
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KEEP COPY FORYOUR RECD;
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A '® RECEIVED BY
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promise
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
greater at the time of your building permit application.
A $200.00-- -refun able deposit is being collected for any residential remodel,
.additiQn'or access ry building valued under $10,000.
A $50.00 refund le deposit is being collected for all misc. permits.
The Cit y r ewes the right to not refund this deposit if any of the following
Qty s 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 j
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. 7
C tractor /Owner Contractor /Owner
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City of Blair
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Date
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CITY Of I)LAIQ
pro �ise of
FENCE PERMIT SUPPORTING DOCUMENTS
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This supporting document includes information dealing with particular zoning
requirements and /or fence permit requirements. It in no way includes ALL particular
zoning items. Also, it is your responsibility to know the City of Blair Zoning Ordinance
Section 1102 requirements that apply to fences, walls and hedges. Please understand
this document is only designed and distributed to aid in your fence permit process. A
copy of the City of Blair Zoning Ordinance is available for your use at the Blair Public
Library or on our website at www.blairnebraska.org
I 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.
ry
Owner /Occupant ContractQ
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City of Blair Date
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218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cityofblair @cl.biair.ne.us
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