MS-2015-00437.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
UIlC�IiI Permit Application
(402) 426 -4191 - Phone
(402) 426 -4195 - FAX
MS- 2015 -00437 ° m;s e or www.blairnebraska.org
05129/2015 bpeterse MISC Residential May 29, 2015
LOCATIONOFIMPROVEMENT: 872 S 16th St, Blair, NE 68008
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ARCHITECT:
s GENERAL Done Right Home Improvements
OWNER: Joel E And Donna R White CONTRACTOR:
7896 Serum Ave
872 S 16th St RALSTON, NE 68127
e BLAIR, NE 68008 -0000
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NATURE OF WORK STRUCTURE
Fence Primary Residence
PROJECT NAME
PERMIT EXPIRES 05/28/2017
872S16thSt- 150529 -Fence 6/29/2015
ESTIMATED COMPLETION DATE
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DESCRIPTION OF WORK
4' chain link to sit on south and west side.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Homeowner Joel White
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 intention of the undersigned or any alteration or change from this application without approval of the
Buildin Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
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CITY OF , NEBRASKA l
Phone 402 - 426 -4191
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THANK YOU KEEP THIS,COPY FOR YOUR RECORDS,
NO
RECEIVED BY
Pounds Printing, Blair, NE 68008
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FENCE PERMIT SUPPORTING DOCUMENTS
This supporting document includes information dealing with particular code
requirements and/or fence permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility to know the 2006 International Building
Code requirements that apply to your project. Please understand this document is only
designed and distributed to aid you in your fence permit process. A copy of the
International Building Code is available for your use at the Blair Public Library.
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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.
r ccupant Contractor
City of Blair e
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218 South 16th Street • Blair, Nebraska 68008 < 402 - 426 -4191 • Fax 402 -426 -4195 E -mall cltyofblalr @cl.blalr.ne.us
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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 refundable deposit is being collected for any residential remodel,
addition o ccessory building valued under $10,000.
/A $50.00 ref ndable deposit is being collected for all misc. permits.
( The—Cify 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.
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.
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ntr c r /Owner Contractor /Owner
City of Blair
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