MS-2010-00215.tif CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone 426-4195 - FAX
MS - 2010 - 00215 ° ' 0 (
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11/0812010 bpeterse MISC Commercial November8,2010
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LOCATIONOFIMPROVEMENT: 554 S 13th St, Blair, NE 68008
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ARCHITECT: GENERAL Sandvold, Jim
OWNER: Terry R And Sandra L Hansen CONTRACTOR: 351 Grant
7457 Windhill Ln Blair, NE 68008
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Window /Door Replacement Primary Office
PROJECT NAME PERMIT EXPIRES 11/07/2012
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5545 13thSt- 101108 - Windows
ESTIMATED COMPLETION DATE 2010 -12 -08
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DESCRIPTION OF WORK
Pulling out 4 windows and putting 2 new ones in. Other 2 windows will be replaced with composite wood siding.
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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 Of' cia�h I constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
application.
Date
Signature of App (cant
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