MS-2010-00084_0001.tif i
/��� CITY OF BLAIR
j 218 S. 16TH STREET
1 1 BLAIR, NEBRASKA 68008
B uilding Permit Application (402)426- 4191 -Phone
9 _ (402) 426 -4195 - FAX
MS 2010 - 00084 p ' 0 _ °� a ° °�� www.blairnebraska.org
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08/27/2010 MISC Residential August 27,
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LOCATION OF IMPROVEMENT: 2470 Hollow Rd, Blair, NE 68008
ARCHITECT: GENERAL
CONTRACTOR: g
OWNER: Ben -Shin And Luh- Hsiang Wang 164 S I is Roofin &Sheet Metal
164 S st St
30 1283 s Hwy Blair, NE 68008
BLAIR, NE 68008 -0000
NATURE OF WORK PROPOSED USE
Misc. Permit Primary Residence
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PROJECT NAME PERMIT EXPIRES 08/26/2012
2470HollowRd- 100827- Roofing ESTIMATED COMPLETION DATE 2010 -08 -31
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DESCRIPTION OF WORK
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Tearing off and replacing with asphalt shingles. Some gutters also
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor REScheck /COMcheck SUBMITTED: NA
DEPOSIT HELD: BUILDING PLANS SUBMITTED: NA
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 'th or without the intention of the undersigned or any alteration or change from this application without approval of the
B Idi g Official, shall consf} sufficient ground for the revocation of any permit issued which was based on the approval of this
a pli tion.
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Date
Signat of Applicant
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