734_0001.tif CITYOFBLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
one
u ng erm pp ica ion (402) 426-4195 - FAX
MS-2014-00315 Ise ot www.blairnebraska.org
06112/2014 MISC Residential June 12, 2014
A
f LOCATION OFIMPROVEMENT: 734 N 14th St, Blair, NE 68008
i0m,
ARCHITEC
GENERAL The Roofing Moose
OVVNER: Terry J And Jean Ray CONTRACTOR: 20164 Husker Dr
. . . . . . . . . . . . . .
- - - - - - - - - - - - - - - - -
734 N 14th St GRETNA, NE 68028
BLAIR, NE 68008-0000
nk�,' - �L
�,
J
NATURE OF WORK PROPOSED USE
Storm Repair Primary
PERMIT EXPIRES 0611112016
PROJECT NAME
734Nl4thSt-140612-Storm Damage ESTIMATED COMPLETION DATE 12/3112014
DESCRIPTION OF WORK
Replacing the roof, steel siding and gutters
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheckICOMcheck SUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA
NMI,
Aw
@i
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 [lie approval of this
n.
LA
Date
Signature of Applicant