MS-2014-00311.tif i
CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
Building Permit Application (402) 426 -4191 - Phone
'0�0�,� (402) 426 -4195 -FAX
MS-201 4-00311
!s$ of u www.blairnebraska.org
06/12/2014 bpeterse MISC Residential June 12, 2014
LOCATIONOFIMPROVEMENT: 2460 Hollow Rd, Blair, NE 68008
ARCHITECT:
GENERAL J -Tech Construction
OWNER: Kathy R Duke CONTRACTOR: 7730 N 56th St Unit #1C
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2460 Hollow Rd LINCOLN, NE 68514
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair Primary Residence
PROJECT NAME PERMIT EXPIRES 06/1112016
2460HollowRd- 140612 -2014 Storm Damage 12/31/2014
ESTIMATED COMPLETION DATE
DESCRIPTION OF WORK
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Replacing asphalt shingles on the roof.
DEPOSIT PAID BY: SITE PLAN SUBMITTED: NA
Contractor
REScheck/COMcheckSUBMITTED: NA
DEPOSIT STATUS: BUILDING PLANS SUBMITTED: 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, 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 j
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
ding Officia al onstitute sufficient ground for the revocation of any permit issued which was based on the approval of this
licatio
Date
S gnature of Appli
CITY OF s NE BRASKA
Phone 402- 426 -4191
RECEIVED OF:
ADDRESS
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CITY, STATE, ZIP CODE
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THANK YOU KEEP THIS COPY FOR YOUR RECORDS. I
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RECEIVED BY J
Pounds Printing, Blair, NE 68008 - 3�