cn-2015-00945.tif CITYOF BLAIR
218 S.16TH STREET
BLAIR,NEBRASKA 68008
® (402)426-4191 - Phone
Building 1" It Application (402)426-4195-FAX
CN-2015-00945 0110 Ise of a�°�� www.blairnebraska.org
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11113/2015
COM-NEW Commercial November24,2015
LOCATION OF IMPROVEMENT: 13092 Us Hwy 30, Blair, NE 68008
ARCHITECT:
GENERAL Jorgensen Contracting, Inc.
OWNER: Donna J And John M Co-Trustees Henton CONTRACTOR:
530 Front St
3013092 Us Hwy Blair, NE 68008
BLAIR,NE 68008-0000
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NATURE OF.WORK STRUCTURE
New Construction Primary
PROJECT NAME PERMIT EXPIRES 11/12/2017
13092Us Hwy 30-151112-New Construction ESTIMATED COMPLETION DATE 6/30/2016
DESCRIPTION OF WORK
36' x 104' Wick building for machinery storage.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: Received
Contractor
RES check/CO Mcheck SUBMITTED: 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.
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
appliation.
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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.
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.
1
Owner/Occupant ntra for
City of Blair Date
EQUAL NUU91N0
OPPOpTUNITY
218 South 16th Street• Blair,Nebraska 68008 • 402-426-4191 • Fax 402-426-4195 E-mail cityofblair@ci,blair,ne,us