MS-2014-00281.tif I I
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CITYOF GLAIR
G 210 S. 16TH STREET
BLAIR, NEBRASKA 68008
Application
(402 426 -4131
Building Permit -Phone
(402) 4264195 - FAX
MS- 2014- 00281 /so 01 AJa�ti www.blairnebraska.org
0610$12014 IUl1SC
Residential June 10, 2014
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LOCATIONOAMPROVEMI NT. 995 N 14th St, Blair, NE 68008
ARCHFrECT: GENERAL_ The Roofing Moose
5 OWNER: Eric And Kimberly M Grossoehme CONTRACTOR: 20164 Husker Dr f
i ° 995 N 14th St GRETNA, NE 68028
BLAIR, NE 68008 -2781
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NAT URE OF WORK PROPOSED USE
Roofing /SoffitlEaves /Gutters Primary residential
PERMIT EXPIRES 0610812016
PROJECT NAME
995N14thSt- 140609 -2014 Storm Repair
ESTIMATED COMPLETION DATE 12131/2014
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DESCRIPTION OF WORK
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Reroof, siding, windows following hail storm
DEPOSIT PAID BY: SITE PLAN SUBMITTED NA
Contractor
RESchecklCOMcheckSUBMITTED NA
DEPOSIT STATUS: 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 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 of Applicant
CITY OF BLAIR, NEBRASKA
Phone 402 - 426 -4191
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THANKYOU l KEEP THIS; COPY FOR YOUR RECORDS.
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RECEIVED BY i
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Pounds Printing, Blair, NE 68008