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pa (3).tif Tom Kupfer 402 - 905 -2999 p.3 Jun. 18, 2014 9 ,15AM CITY 0.: B LA." R (402. 426.4191) Ng, 3631 P. 1 CtTY'OFBLAIR 219 S.16TH STREET BLAIR, NEBRASKA 6 6008 j . - Building Permit Application (40.2)428 4 191 . Phone I (402) 4264195 - FAX tUt'a"- 2Q'�4 -Qf 4 1 �,�� a �� � www.bIatrmebraska.org I 1 l)6f181�f114 bpeterse MI Ir Residential June 18, 2014 LOCA110NOFIMPROV15MENT: 1 244 S 13th Ave, Blelr, NE GOODS R ARCHITECT: GENERAL 315 C©nstruction Inc e MIER: Cody James Olsen CONTRACTOR: 7610 N 15 41h Cir 1244 S 13th Ave BENNINGTON, NE 68047 BL.AIR, NE 68008 -0000 SELECTED CH O ~ NATURE OF WORK PROPOSED USE Storm Repair Primary Residence i PROJECT NAME PERMIT EXPIRES 0011701$ 1244513thAve 140610.2014 Storm Damage ESTIMATED COMPLETION DATE 1213112014 DESCRIPTION OF WORK Reroofing with asphalt and gutters. DEPOSIT PAID I8Y1 SITE PLAN SUBMITTED: NA contractor RE8cheok1 SUBMITTED. NA DEPOSIT STATUS: BUILDING PLANS SUBMITTED: NA AFFA DAVIT OF APP LICANT 1. No work will be started before a permit is ISSUED AND POSTED. 2. For commercial permits, a set of ptans for this project mast 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 dves not constitulle lssuance of this building permit. It is father 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 coOeslordinances of the City of Blair and the State of Nebraska. Any omission of or misrepresentation of fact with or without the i n t ent io n of the undersigned or any alteration or change from this application without approval of the Building Official, 0 alli constitut affi -lent ground for the revocation of any permit issued which was based on the approval of INS applicati �.... Signature of Appil:an Date i I i F