20121005163606140_0001.tif i
10/05/2012 12:17PM FAX 4023332704 ELITE EXTERIORS iA0001/0003
'CITY OF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 611008
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Building POft it A pplicati on (402)426- 4181 - Phone
(402)426-4195-FAX
MS °14 d+ CON www.blairnebraska.org
10102/2012 bpeterse MISC Residential October 2, 2012
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LOCATIONOPIMPROVEMENT: 4117 Gorey Cyr, Blair, NE 68008
ARCMITFC: !
GENaVL Elite Exteriors
y r OMER: Marc F And Karon R Gengonbach CONTRACTOR, 201 Oakcreek Dr
1117 Carey Dr Lincoln, NE 68528
Bi.AiR, NE 68008 -0000
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NATURE OF WORK PRO OSTD USE
Biding Pr L ary Residence
PROJECT NAME
P ERMI T EXPIRES 10 /02/2014
1 11 TCoreyDr -1 21002- Siding
ESTIMATED COMPLETiON DATE 101 31/2012
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DESCRIPTION OF WORK
Replacing siding with vinyl
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DEPOSIT PAID BY: SiTE PLAN SUBMITi ER; NA
Contractor
RESchecklCOMeheckSUBMITTED: NA
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DEPOSIT STATUS: BUILDING! PLANS SiUSMITTED: NA
$50
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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, I tllating 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 propoq work. In accordance with the :specifications get forth above and
in accordance with the codeslordinances of the City of Blair and the State of Nebraska,. Any ornission 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.
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Signature ofApplioant Date
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