1761 park_0001-1.tif CITYOF BLAIR
218 S. 16TH STREET
BLAIR, NEBRASKA 68008
(402) 426 -4191 - Phone
uilding ermit pplication
MS- 2'14 -0372 .o,.o� �d`'`�� (402) 426 -4195 -FAX
ISe of a www.blalrnebraska.org
06/1612014 MISC Residential June 16, 2014
LOCATION OF IMPROVEMENT: 1761 Park St, Blair, NE 68008
ARCHITECT:
� GENERAL The Home Improvement Store LLC
OWNER: Lisa Danielle Hiykel CONTRACTOR: 6677 Sorensen Pkwy
1761 Park St OMAHA NE 68104
BLAIR, NE 68008 -0000
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NATURE OF WORK PROPOSED USE
Storm Repair Primary
PROJECT NAME PERMIT EXPIRES 06115/2016
1761 ParkSt- 140616 -2014 Storm Damage
ESTIMATED COMPLETION DATE 12/31/2014
DESCRIPTION OF WORK
Replacing roofing, gutters, siding and some windows
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
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 without the intention of the undersigned or any alteration or change from this application without approval of the
Buildi O icial, shall constitute sufficient ground for the revocation of any permit issued 'which was based on the approval of this
appli a '
Sig ture f Applicant to