PB-2015-00809.tif i
CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
uildin @Pipit Application (402)426-4191 -Phone
(402)426-4195-FAX
PB-2015-00809 ise of q° www.blairnebraska.org
09/22/2015 POLEBARN Residential September 22,2015
LOCATIONOFIMPROVEMENT: 9071 Cord P33, Blair, NE 68008
` ARCHITECT:
GENERAL Morton Buildings, Inc.
a' OWNER: Howard D Jr And Kristie E Thompson CONTRACTOR:
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PO Box 177
�s 9071 Co Rd P33 Onawa, IA 51040
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BLAIR,NE 68008-0000
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NATURE OF WORK STRUCTURE
New Construction Accessory Building
PROJECT NAME PERMIT EXPIRES 09/21/2017
9071Cord P33-150922-Pole Building ESTIMATED COMPLETION DATE 12/1/2015
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DESCRIPTION OF WORK
30 x 32 Pole Building - Different Contractor will pull an electrical permit and a permit for the cement floor
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Pending
Contractor
REScheck/COMcheckSUBMITTED: NA
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.
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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.
9 ,,2® / 5
Date
Signature of Applicant
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CITY OF
NEBRASKA
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Phone 402-426-4191
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RECEIVED OF:
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ADDRESS
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CITY,STATE,ZIP CODE
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THANK YOU KEEPTHIS COPY FOR YOUR RECORDS.
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RECEIVED BY
Pounds Printing,Blair,NE 68008
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IL I Of BLAIQ
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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
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.
ner/Occupant Contractor
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City of Blair
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10=1111-
218 South 16th Street• Blair,Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cltyofblalr@cl,blair,ne,us E
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Promise
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BUILDING PERMIT DEPOSIT AGREEMENT j
$500.00 ref dable deposit is being collected for any new commercial, new
Lresidential, a any additions, remodels and accessory building valued $10,000 or
reater a 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
Department.
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tractor/Owner Contractor/Owner
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City of Blair
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