SA-2015-00257.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
402 426 -4191 - Phone
B uilding Permit Application (402) 426 -4195 - FAX
SA- 2015 -00257 Ise 01 q o www.blairnebraska.org
04/16/2015 SIGN -AWN Commercial May 5, 2015 77
LOCATION OF IMPROVEMENT: 1523 Washington St, Blair, NE 68008
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ARCHITECT;
° GENERAL Omaha Neon Sign Co., Inc.
OWNER: Washington County Bank CONTRACTOR:
1120 N 18th St
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PO Box 248 Omaha, NE 68102
w BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Sign Washington County Bank
PROJECT NAME PERMIT EXPIRES 04/15/2017
1523WashingtonSt- 150416 -Sign ESTIMATED COMPLETION DATE 10/16/2015
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DESCRIPTION OF WORK
Signs for Washington County Bank. Monument and wall signs. Will have electric.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
RE y e K
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 own or agent agrees to perform the proposed work in accordance with the specifications set forth above and
in accordance ' the codes /ordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of
fact with o itho the in ti on of the undersigned or any alteration or change from this application without approval of the
Buildin fficial, shall constit to sufficient gro or the revocation of any permit issued which was based o the approval of this
a ation.
Signature of Applic t Date
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CITY OF 9
Phone 402 - 426 -4191
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RECEIVED OF. j
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CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS COPY FOR YOUR RECORDS.
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RECEIVED BY'
Pounds Printing, Blair, NE 68008
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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 refundable deposit is being collected for all misc. permits.
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The City reserves the right to not refund this deposit if any of the following
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.
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
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
Departme
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Contrac r /Owner Contractor /Owner
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City of Blair
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Date
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