1142 Corey Application.tif CITYOFBL.AIR
218 S.16TH STREET j
BLAIR, NEBRASKA68008
• Build Permit Appiication (442) 4264191 - Phone
Y (442) 426.4195 - FAX
SP- 2015 -00280 r anj8e Of QVQ�l� www.blairnebraska.org
04121/2075 bpeterse SWIMFOOL Residential May 1, 2015
LOCATIONOFIMFROWMENT: 1142 Corey Or, Blair, NE 68048
CT ' GeERAL SELF
a OVIRdiR Rory G And Mikki S Mulially TWTOR:
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° 1142 Corey Or Blair, NE 68008
BLAIR, NE 6800MOOD
NATURE OF WORK STRUCTURE
Swimming Pool Primary
OD C4 PROJECT NAME PERMIT EXPIRES oal�tif201
1142CoreyDr- 150421•Swlmming Pool ESTIMATED COMPLETION DATE 711812015
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DESCRIPTION OF WORK
18 x 36 7nground pool with electrical pump, gas heater and reconstructing fence from storm damage.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
ID REScheckfCOMcheckSUBMITTED: NA
C4 DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
° $5
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1, No work will be started before a permit is ISSUED AND POSTED.
2. Forcommercial permits, a set of plans for this project must be submitted to the Nebraska State Fire Marshal's Office for review.
w 3, Separate permits are required for electrical, plumbing, heating, ventilating and air conditioning, and septic system.
t2 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
c in accordance with the codeslordinances 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 nsbtute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Signat re of pplicant Date
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CITY 1, NEBRASKA
Phone 402 -426 -4191
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CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS COP FO YOUR RECORDS.
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Pounds Printing,: Blau, NE 68008
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8UILD1NG PERMIT DEPOSIT AGREEMENT
A $500.40 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,
C addition or accessory building valued under $'14,040.
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CXD
CD A $60.00 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.
B) Storm Water Management Plan inspection not - obtained. (if Required)
If any or all of these situations occur during construction, you may forfeit your
deposit.
hereby agree to the above conditions, and understand that should any or "
01i all of the above situations occur, the building permit deposit SHALL be forfelted or
discounted upon the discretion of the City of Blair, Building and Inspections
Department.
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Co trac or /Owner ContractorlOwner
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City of Blair
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Date
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CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008 !
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Building Permit Application (402) 426 -4191 - Phone
(402) 426 -4195 - FAX
SP- 2015 -00280 ise °, a www.blairnebraska.org
04121/2015 SWIMPOOL Residential April 21, 2015
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LOCATIONORMPROVEMENT: 1142 Corey Dr, Blair, NE 68008
ARCHITECT:
GENERAL SELF
OWNER: Rory G And tAikki S Mullally CONTRACTOR:
142 Corey Dr Blair, NE 68008
BLAIR, NE 68008 -0000
= r c r :-6 3 sr ' M✓
NATURE OF WORK STRUCTURE
Swimming Pool Primary
I
PROJECT NAME PERMIT EXPIRES 04120/2017
1142CoreyDr-1 50421 -Swimming Pool ESTIMATED COMPLETION DATE 7/1812015
DESCRIPTION OF WORK
18 x 36 inground pool with electrical pump, gas heater and reconstructing fence from storm damage.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
$50
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.
Date
Signaere of Adli6 nt