MS-2012-00269_0001.tif I
CITY OF BLAIR
- 218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402)426- 4191 -Phone
(402) 426 -4195 - FAX
MS- 2012 - 00269 °' M �, a °' www.blairnebraska.org
07/12/2012 MISC Residential July 12, 2012
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LOCATIONOFIMPROVEMENT: 252 N 22nd St, Blair, NE 68008
I s ARCHITECT: GENERAL Frank Gabby Siding & Windows
OWNER: Van Vieet, Ronald C and Lisa Faye CONTRACTOR: P O Box 85
2982 Herbert Henry Ln Blair, NE 68008
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FORT CALHOUN, NE 68023 -0000 C
NATURE OF WORK PROPOSED USE
Roofing/Soffit/Eaves/Gutters Primary Residence
PROJECT NAME PERMIT EXPIRES 07/12/2014
252N22ndSt- 120712 - Roofing ESTIMATED COMPLETION DATE 7/31/2012
DESCRIPTION OF WORK
Tearing off down to the decking and replacing with asphalt shingles.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck /COMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
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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 constitut fficient ground for the revocation of any permit issued which was b sed on the approval of this
ga plication.
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of Applicant