MS-2014-03192.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426-4191 - Phone
Building Permit Application (402) 426-4196 - FAX
MS-2014-03192 'Oise ol www.blairnebraska.org
Residential OcTober 2014
014 bpeterse MISC
LOCATION OF IMPROVEMENT: 1051 Fairview Dr, Blair, NE 68008
ARCHITECT: GENERAL SELF
OWNER: Betty A Denison CONTRACTOR:
1051 Fairview Dr Blair, NE 68008
BLAIR, NE 68008-0000
RUIN
NATURE 0 TRUCTURE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 10/28/2016
105IFairviewDr-141029-2014 Storm Damage ESTIMATED COMPLETION DATE 1213112014
DESCRIPTION OF WORK
Siding, facia and soffet
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
j
ON,
SMIC
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
Building Official, shall c stitute sufficient ground for the revocation of any permit issued which was based on the approval of this
applic i n. I i
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Date
Signature of A ant
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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
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.
A $50.00 re a dable deposit is being collected for all misc. permits.
.............
The --re rves the right to not refund this osit if any of the following
conditions occur ing the construction p�e
limber, owner or
1) Theft of Ovate rvtce by th p� general contractor.
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2) All permits have n � obtained.
3) All required inspe 'ons a not been obtained.
4) Occupancy urs prior to a i ' spection.
5) The pr ' ct is completed without a fin " spection being done.
6) S - m Water Management PIan inspection obtained. (If Required)
If any o all of these situations occur during construction, you may forfeit your
deposit.
1 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.
ontractor/ caner Contractor /Owner
City of Blair
ate