RN-2015-00025_0001.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
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Building P ermit Application (402) 426 -4191 - Phone
� „o (4oz) 426-4196 - FAx
RN- 2015 -00025
tae of a www.blairnebraska.org
01/19/2015 RES - NEW Residential January 22, 2015
LOCATIONOFIMPROVEMENT: 2328 Fieldcrest Dr, Blair, NE 68008
ARCHITECT:
GENERAL Huber Builders
OWNER: Caleb J And Sydney M Pokorney CONTRACTOR:
" 2010 Fieldcrest Dr
1270 Deerfield Blvd Apt 137 BLAIR, NE 68008 -0000
BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
New Construction Primary Residence
PROJECT NAME PERMIT EXPIRES 01/18/2017
2328FieldcrestDr- 150119 -1 ESTIMATED COMPLETION DATE 11119/2015
DESCRIPTION OF WORK
2 story, 4 bedroom, 2.5 bath unfinished basement with rough in, 2 car garage (tandem) Stick framed roof.
I
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck/COM check SUBMITTED: Received
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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 constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
i9rlatureof Apljc
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