1455 per.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Budding Permit Application (402) 426 -4191 -Phone
MS- 2014 -00328 A`e mhe 01 g ( www.blai nebraska org
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06/13/2014 MISC Residential June 13, 2014
LOCATIONORMPROVEMENT: 1455 S Hwy 75, Blair, NE 68008
ARCHITECT; GENERAL Jim La Hood Construction, Inc.
OWNER: Virgil G And Shirley E Wrich CONTRACTOR: 802 S. 50th Ave
751455 s Hwy Omaha, NE 68106
BLAIR,NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair Primary
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PROJECT NAME PERMIT EXPIRES 06/12/2016
1455SHwy 75- 140613 -Storm Damage ESTIMATED COMPLETION DATE
1213112014
DESCRIPTION OF WORK
Replacing roof j
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: 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
B ilding Official, shall constitute sufficient ground for the revocation of any permit issued which was based on the approval of this
a plication. 11 j
Date
Si ature of App'Ii