MS-2013-00497_0001.tif i
Oct 2713 08 :39a p,1
CITYOFBL AIR
218 $.16TH STREET
BL-AiR, NEBR,4SKA68006
B uilding 7 Pe rmit (402) 426-4191 - Phone
r (402) 426 -4195 - FAX
MS- 201 - 00497 ° °t Q ub�`� www.blairnebraska.org
10/2312013 bpeterse MISC Resider #ial October 23, 2013
LOCATIONdFIMPRQVEMENT: 205 Jackson St, Blair, NE 6$00$
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ARCMECT:
GENERAL Valley Boys, Inc.
OVVNEF Marjorie Dyas coNTRACTOR 10547 Bondesson Cir
=, 205 Jackson St Omaha, NE 6$722
'�^x BLAIR, NE 68008 -0000
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NATURE OF WORT{ PROPOSED USE
RoofinglS,off it/EavesiGutters - - - -- - - - - -- - Rdmary_Residence
_ .. ...................... _ _. _.. ......_ ............_......._ . _ ....... .. _ . .................. _... _
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PROJECT NAME PERMIT EXPIRES 10/23/2015
205JacksonSt- 131D23-Roofing
ESTIMATED COMPLETION DATE 1013112013
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DESCRIPTION OF WORK
Re -roof with asphalt and gutters.
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DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
NA
REScheck1COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
NIA
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1. No work will be started before a permit is ISSUED AND POSTED.
tt t h a ire Marshal's Office for review.
2. For commercial ermits a set of tans for this project must be submitted o the Nebraska Stat F
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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 codeslordinances 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
a%15 ion.
ign ure of Applicant Date
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