1665 Neb Application.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application
(402) 426 -4191 -Phone
��.Ms ��' (402) 426 -4195 - FAX
RN-2015-00648 ° ris e a ° www.blairnebraska.org
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08107/2015 bpeterse RES -NEW Residential August 27, 2015
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LOCATIONOFIMPROVEMENT: 1665 Nebraska St, Blair, NE 68008 {
ARCHITECT:
GENERAL Habitat for Humanity of Omaha, Inc.
OWNER: Habitat For Humanity Of Omaha Inc CONTRACTOR:
1701 N 24th St
r " 1701 N 24th St Omaha, NE 68110
# OMAHA, NE 68110 -0000
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NATURE OF WORK STRUCTURE
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New Construction Primary Residence
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PROJECT NAME PERMIT EXPIRES 08/2612017
1665NebraskaSt- 150807 -New Residential ESTIMATED COMPLETION DATE 12/712015
DESCRIPTION OF WORK
New 3 bedroom 1 bath Habitat Home - No garage. Basement will be unfinished with a rough in bath. Trussed roof.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
REScheck /COMcheck SUBMITTED: Pending
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: Received
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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
Building Official, shall constitute sufficient ground for the revocation of any permit issued which was baseA n the approval of this
application.
gnature If Applica t ate
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BUILDING PERMIT SUPPORTING DOCUMENTS
This building permit packet includes various items dealing with particular code
requirements and /or building permit requirements. It in no way includes ALL particular
code items. Also, it is your responsibility 'to know the 2009 International Building
Code requirements that apply to your project. Please understand this packet is only
designed and distributed to aid you in your building permit process. A copy of the j
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.
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Owner /Occupant §eo 4 n - tractor
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City of Blair ate
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218 South 16th Street • Blair, Nebraska 68008 • 402 - 426 -4191 • Fax 402 - 426 -4195 E -mail cityofblalr @cl,blair,ne.us
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